Provider Demographics
NPI:1891872503
Name:KCRCMD INC
Entity Type:Organization
Organization Name:KCRCMD INC
Other - Org Name:MICHAEL NAVATO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:NAVATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-795-1968
Mailing Address - Street 1:254 NE TUDOR RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5696
Mailing Address - Country:US
Mailing Address - Phone:816-795-1968
Mailing Address - Fax:888-642-0207
Practice Address - Street 1:254 NE TUDOR RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5696
Practice Address - Country:US
Practice Address - Phone:816-795-1968
Practice Address - Fax:888-642-0207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOM368812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO260028685OtherRAILROAD MEDICARE
MO202416061Medicaid
KS0007052AMedicare ID - Type Unspecified
MO202416061Medicaid
MOE59772Medicare UPIN