Provider Demographics
NPI:1639174253
Name:ROWE, VERNON D (MD)
Entity Type:Individual
Prefix:DR
First Name:VERNON
Middle Name:D
Last Name:ROWE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 HILLSIDE ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218-9071
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8550 MARSHALL DR STE 100
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-9836
Practice Address - Country:US
Practice Address - Phone:913-827-4200
Practice Address - Fax:913-827-4201
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-176582084N0400X, 2084N0400X
CA1501242084N0400X
MOR1C162084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201855004Medicaid
431252659OtherCHAMPUS
MO023450OtherFAMILY HEALTH PARTNERS
2081146OtherAETNA US HEALTHCARE HMO
431252659OtherMIDAMERICA HEALTH
KS100196830AMedicaid
10001031601OtherCOMMUNITY HEALTH PLAN MO
109507OtherHEALTHLINK-NCPPO
09413017OtherBCBS KANSAS CITY
4001886OtherAETNA US HEALTHCARE
MO6233817Medicare ID - Type Unspecified
130005107Medicare ID - Type UnspecifiedRAILROAD MEDICARE
109507OtherHEALTHLINK-NCPPO
C50334Medicare UPIN