Provider Demographics
NPI:1700840915
Name:RONEY, MELINDA A (MD)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:A
Last Name:RONEY
Suffix:
Gender:F
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:PO BOX 411851
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-1851
Mailing Address - Country:US
Mailing Address - Phone:913-588-1944
Mailing Address - Fax:913-588-2496
Practice Address - Street 1:7405 RENNER RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66217-9414
Practice Address - Country:US
Practice Address - Phone:913-588-8465
Practice Address - Fax:913-588-8529
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR5P55207Q00000X
KS04-35910207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100163120EMedicaid
MOR6P55OtherSTATE LICENSE NUMBER
KSP01577911OtherRR MEDICARE
KS04-35910OtherKS LICENSE
F36417Medicare UPIN
KS04-35910OtherKS LICENSE