Provider Demographics
NPI:1275502502
Name:INDEPENDENT ORTHOPAEDICS AND SPORTS MEDICINE P.C.
Entity Type:Organization
Organization Name:INDEPENDENT ORTHOPAEDICS AND SPORTS MEDICINE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIPPER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:816-221-2663
Mailing Address - Street 1:9800 NW POLO DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64153
Mailing Address - Country:US
Mailing Address - Phone:816-221-2663
Mailing Address - Fax:816-453-6914
Practice Address - Street 1:14119 W. 82ND STREET
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215
Practice Address - Country:US
Practice Address - Phone:816-221-2663
Practice Address - Fax:816-453-6914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207X00000X
KS05-21679207X00000X
MI5101013339207X00000X
MOR7898207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MON604837Medicare PIN
KSN604837BMedicare PIN
C50432Medicare UPIN
N604837AMedicare ID - Type UnspecifiedPROVIDER
N600000AMedicare ID - Type UnspecifiedGROUP