Provider Demographics
NPI:1356321947
Name:PSYCHIATRY ASSOCIATES OF KANSAS CITY PA
Entity Type:Organization
Organization Name:PSYCHIATRY ASSOCIATES OF KANSAS CITY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERMAN
Authorized Official - Middle Name:WARD
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-385-7252
Mailing Address - Street 1:8900 STATE LINE RD
Mailing Address - Street 2:STE 380
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66206
Mailing Address - Country:US
Mailing Address - Phone:913-385-7252
Mailing Address - Fax:913-385-2412
Practice Address - Street 1:8900 STATE LINE RD
Practice Address - Street 2:STE 380
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66206
Practice Address - Country:US
Practice Address - Phone:913-385-7252
Practice Address - Fax:913-385-2412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
31777OtherBCBS KS
00523011OtherBCBS KC
A910000Medicare ID - Type Unspecified
A910000BMedicare ID - Type Unspecified
A910000AMedicare ID - Type Unspecified
110513Medicare ID - Type Unspecified