Provider Demographics
NPI:1275675647
Name:LERMA, RICARDO JR (DC)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:
Last Name:LERMA
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2066 SW RACHEL LN
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082-4065
Mailing Address - Country:US
Mailing Address - Phone:816-525-0941
Mailing Address - Fax:816-353-7578
Practice Address - Street 1:6600 E 87TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64138-2733
Practice Address - Country:US
Practice Address - Phone:816-353-7577
Practice Address - Fax:816-353-7578
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003004143111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO7589489OtherAETNA PROVIDER NUMBER
MO32410018OtherBCBS PROVIDER #
MO32410018OtherBCBS PROVIDER #
MO7589489OtherAETNA PROVIDER NUMBER
MOQ130000Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER