Provider Demographics
NPI:1659592046
Name:GROWNEY, JAMES L (PA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:L
Last Name:GROWNEY
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:801 ATCHISON ST
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-2352
Mailing Address - Country:US
Mailing Address - Phone:913-367-5020
Mailing Address - Fax:
Practice Address - Street 1:801 ATCHISON ST
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-2352
Practice Address - Country:US
Practice Address - Phone:913-367-5020
Practice Address - Fax:913-367-1089
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS15-01170OtherLICENSE #
KS1437350741OtherGROUP NPI NUMBER
KS460484OtherCHILDRENS MERCY FAMILY HEALTH PARTNERS
KS111327OtherBLUE CROSS BLUE SHIELD OF KANSAS GROUP NUMBER
KS100087100AMedicaid
1078175OtherNCCPA
MO05634011OtherBLUE CROSS BLUE SHIELD OF KANSAS CITY GROUP NUMBER
KS111327Medicare PIN