Provider Demographics
NPI:1952047839
Name:ORTHOPEDIC SURGERY AND SPORTS MEDICINE OF KANSAS CITY OSSM
Entity Type:Organization
Organization Name:ORTHOPEDIC SURGERY AND SPORTS MEDICINE OF KANSAS CITY OSSM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ORTHOPEDIC SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-722-1222
Mailing Address - Street 1:24510 W 51ST ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226-2774
Mailing Address - Country:US
Mailing Address - Phone:913-424-9455
Mailing Address - Fax:
Practice Address - Street 1:23401 PRAIRIE STAR PKWY STE B230
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66227-7268
Practice Address - Country:US
Practice Address - Phone:913-722-1222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty