Provider Demographics
NPI:1558363838
Name:CARONDELET EMERGENCY PHYSICIANS INC
Entity Type:Organization
Organization Name:CARONDELET EMERGENCY PHYSICIANS INC
Other - Org Name:ST JOSEPHS EMERGENCY PHYSICIANS INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDNET
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-942-4400
Mailing Address - Street 1:PO BOX 11347
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32120-1347
Mailing Address - Country:US
Mailing Address - Phone:386-274-7800
Mailing Address - Fax:386-274-7801
Practice Address - Street 1:1000 CARONDELET DR
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4673
Practice Address - Country:US
Practice Address - Phone:816-942-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD100341207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL140684700OtherST JOSEPH'S FEDERAL WC
MO13247011OtherBCBS
MO506972405Medicaid
CU0181OtherRAILROAD MEDICARE
MO506972405Medicaid