Provider Demographics
NPI:1790755486
Name:POWELL, JAMES E (MS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:POWELL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 W 74TH ST # 150
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2282
Mailing Address - Country:US
Mailing Address - Phone:913-384-5880
Mailing Address - Fax:913-384-9612
Practice Address - Street 1:9535 STATE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66111-1815
Practice Address - Country:US
Practice Address - Phone:913-334-5621
Practice Address - Fax:913-384-9612
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS802231H00000X
MO605231H00000X
KSCE564237700000X
MO000397237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSK874211Medicare PIN
R30532Medicare UPIN
KS115330Medicare PIN
MOK874211AMedicare PIN