Provider Demographics
NPI:1437299062
Name:OLATHE HEALTH PHYSICIANS, INC.
Entity Type:Organization
Organization Name:OLATHE HEALTH PHYSICIANS, INC.
Other - Org Name:CARDIOLOGY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT/CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIERNEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRASSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-791-4461
Mailing Address - Street 1:20333 W 151ST ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-5350
Mailing Address - Country:US
Mailing Address - Phone:913-791-4461
Mailing Address - Fax:791-324-8656
Practice Address - Street 1:20805 W 151ST ST
Practice Address - Street 2:SUITE 400
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7249
Practice Address - Country:US
Practice Address - Phone:913-780-4900
Practice Address - Fax:913-780-0949
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OLATHE HEALTH PHYSICIANS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100456110AMedicaid
KS100456110AMedicaid
KS110828Medicare PIN