Provider Demographics
NPI:1942299268
Name:MIDWEST NEPHROLOGY CONSULTANTS PA
Entity Type:Organization
Organization Name:MIDWEST NEPHROLOGY CONSULTANTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SYD
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-276-1770
Mailing Address - Street 1:2340 E MEYER BLVD STE 480
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1116
Mailing Address - Country:US
Mailing Address - Phone:816-276-1770
Mailing Address - Fax:816-276-1703
Practice Address - Street 1:2340 E MEYER BLVD STE 480
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1116
Practice Address - Country:US
Practice Address - Phone:816-276-1700
Practice Address - Fax:816-276-1703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-19
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO502448905Medicaid
KS100213720AMedicaid
MO3730000BMedicare PIN
MO3730000Medicare PIN
KS100213720AMedicaid