Provider Demographics
NPI:1245404482
Name:ROBERT A SHEMWELL DPM LLC
Entity Type:Organization
Organization Name:ROBERT A SHEMWELL DPM LLC
Other - Org Name:DR. ROBERT A. SHEMWELL, DPM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-842-3663
Mailing Address - Street 1:2700 CLAY EDWARDS DR STE 370
Mailing Address - Street 2:
Mailing Address - City:N KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3270
Mailing Address - Country:US
Mailing Address - Phone:816-842-3663
Mailing Address - Fax:816-842-2274
Practice Address - Street 1:2700 CLAY EDWARDS DR STE 370
Practice Address - Street 2:
Practice Address - City:N KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3270
Practice Address - Country:US
Practice Address - Phone:816-842-3663
Practice Address - Fax:816-842-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00739213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO23857031OtherBCBS
MO6017070002OtherNORIDIAN
MO308885904Medicaid
MO6017070002OtherNORIDIAN