Provider Demographics
NPI:1265489017
Name:ROBINSON, BRENDA N (MD)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:N
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9000
Mailing Address - Fax:913-588-9822
Practice Address - Street 1:7405 RENNER RD
Practice Address - Street 2:KU MEDWEST AFTER HOURS / URGENT CARE
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66217-9414
Practice Address - Country:US
Practice Address - Phone:913-588-8450
Practice Address - Fax:913-588-8423
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-27493207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
25562039OtherBCBS PROVIDER NUMBER
3684262OtherAETNA PROVIDER NUMBER
10001781300OtherCHP PROVIDER NUMBR
KS100361490BMedicaid
481159444OtherJAYHAWK TAX ID
406520OtherFIRSTGUARD PROVIDER NUMBE
25562039OtherBCBS PROVIDER NUMBER
10001781300OtherCHP PROVIDER NUMBR
J61D527AMedicare ID - Type Unspecified
H34662Medicare UPIN