Provider Demographics
NPI:1942252929
Name:BASKINS, REBECCA S (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:BASKINS
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 1:2700 CLAY EDWARDS DR STE 400
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3270
Mailing Address - Country:US
Mailing Address - Phone:816-421-4240
Mailing Address - Fax:816-421-5015
Practice Address - Street 1:2700 CLAY EDWARDS DR STE 400
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3270
Practice Address - Country:US
Practice Address - Phone:816-421-4240
Practice Address - Fax:816-421-5015
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001013313207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205376502Medicaid
MOH69B211Medicare ID - Type Unspecified