Provider Demographics
NPI:1679550974
Name:SCHOOFS, KIMBERLY RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:RENEE
Last Name:SCHOOFS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5810 NW BARRY RD
Mailing Address - Street 2:STE 100
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-1493
Mailing Address - Country:US
Mailing Address - Phone:816-584-8100
Mailing Address - Fax:816-584-8106
Practice Address - Street 1:5810 NW BARRY RD
Practice Address - Street 2:STE 100
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1493
Practice Address - Country:US
Practice Address - Phone:816-584-8100
Practice Address - Fax:816-584-8106
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN47025207N00000X
AZ36196207N00000X
MOMO2010018432207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN218600400Medicaid
AZP00624795OtherRAILROAD MEDICARE
AZ160238Medicaid
AZ160238Medicaid
MOX65000003Medicare PIN
I08588Medicare UPIN
AZZ112106Medicare PIN