Provider Demographics
NPI:1336282573
Name:COMPREHENSIVE HEALTH OF PLANNED PARENTHOOD GREAT PLAINS
Entity Type:Organization
Organization Name:COMPREHENSIVE HEALTH OF PLANNED PARENTHOOD GREAT PLAINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HEALTH SERVICES OPS
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-587-4621
Mailing Address - Street 1:4401 W 109TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1303
Mailing Address - Country:US
Mailing Address - Phone:913-312-1400
Mailing Address - Fax:
Practice Address - Street 1:4401 W 109TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1303
Practice Address - Country:US
Practice Address - Phone:913-345-1400
Practice Address - Fax:913-469-3655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO09841028OtherBCBS OF KC DR ID #
MO05543013OtherBCBS OF KC GROUP ID#
KS200282660BMedicaid
MO209208404Medicaid
KS100308570BMedicaid
MO209208404Medicaid