Provider Demographics
NPI:1194850115
Name:JOHNSON COUNTY NEUROLOGY LLC
Entity Type:Organization
Organization Name:JOHNSON COUNTY NEUROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:KUENY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-508-4090
Mailing Address - Street 1:12140 NALL
Mailing Address - Street 2:SUITE 230
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2503
Mailing Address - Country:US
Mailing Address - Phone:913-661-9434
Mailing Address - Fax:913-661-4688
Practice Address - Street 1:5701 W 119TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3722
Practice Address - Country:US
Practice Address - Phone:913-661-9434
Practice Address - Fax:913-661-4688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO507292209Medicaid
KS200428250AMedicaid
KS200428250AMedicaid
MO507292209Medicaid