Provider Demographics
NPI:1609892785
Name:JOHNSON COUNTY ORTHOPEDICS
Entity Type:Organization
Organization Name:JOHNSON COUNTY ORTHOPEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-782-1148
Mailing Address - Street 1:20920 W 151ST
Mailing Address - Street 2:STE 100
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061
Mailing Address - Country:US
Mailing Address - Phone:913-782-1148
Mailing Address - Fax:913-782-1097
Practice Address - Street 1:20920 W 151ST
Practice Address - Street 2:STE 100
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061
Practice Address - Country:US
Practice Address - Phone:913-782-1148
Practice Address - Fax:913-782-1097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110477Medicare ID - Type Unspecified
4280000KCMedicare ID - Type Unspecified