Provider Demographics
NPI:1326044371
Name:GROUNDS, CARRIE (MD)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:GROUNDS
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 1:9301 W 74TH ST
Mailing Address - Street 2:STE 320
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2207
Mailing Address - Country:US
Mailing Address - Phone:913-491-4020
Mailing Address - Fax:913-491-4725
Practice Address - Street 1:8901 W 74TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2201
Practice Address - Country:US
Practice Address - Phone:913-491-4020
Practice Address - Fax:913-491-4725
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0429640174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1114693595OtherOB/GYN
KS100424700DMedicaid
KS100424700DMedicaid