Provider Demographics
NPI:1578696506
Name:NEPHROLOGY ASSOCIATES MD PA
Entity Type:Organization
Organization Name:NEPHROLOGY ASSOCIATES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHUMACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-474-9353
Mailing Address - Street 1:2790 CLAY EDWARDS DR
Mailing Address - Street 2:SUITE 410
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3276
Mailing Address - Country:US
Mailing Address - Phone:816-474-9353
Mailing Address - Fax:816-474-3627
Practice Address - Street 1:2790 CLAY EDWARDS DR
Practice Address - Street 2:SUITE 410
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3276
Practice Address - Country:US
Practice Address - Phone:816-474-9353
Practice Address - Fax:816-474-3627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100212510AMedicaid
MO501848501Medicaid
KS100212510BMedicaid
KS110460OtherMEDICARE GROUP ID
KS100212510AMedicaid
KS4360000BMedicare PIN
KS110460OtherMEDICARE GROUP ID