Provider Demographics
NPI:1528019502
Name:UNIVERSITY OF KANSAS HOSPITAL AUTHORITY
Entity Type:Organization
Organization Name:UNIVERSITY OF KANSAS HOSPITAL AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:E.
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-588-1270
Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:SUITE 312
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9000
Mailing Address - Fax:913-588-9822
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:PROFESSIONAL SERVICES OF KU HOSPITAL
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-9000
Practice Address - Fax:913-588-9822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
144060800OtherDEPT OF LABOR #
144060801OtherUS DEPT OF LABOR
158900XXXOtherPREFERRED CARE NY
01870018OtherBCBS GROUP NUMBER
35839018OtherBCBS HOSPITALIST GROUP#
MO545681306Medicaid
KS100099470BMedicaid
144060800OtherDEPT OF LABOR #
=========OtherWPS/TRICARE
=========OtherTAX ID
KSCH6866Medicare ID - Type UnspecifiedRR MEDICARE
144060800OtherDEPT OF LABOR #