Provider Demographics
NPI:1972551406
Name:REANEY, JOHN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:REANEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9233 WARD PKWY
Mailing Address - Street 2:SUITE 230
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-3366
Mailing Address - Country:US
Mailing Address - Phone:816-389-6030
Mailing Address - Fax:816-389-6034
Practice Address - Street 1:12300 METCALF AVE
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1324
Practice Address - Country:US
Practice Address - Phone:816-389-6030
Practice Address - Fax:816-389-6034
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO106533207L00000X
KS0427748207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207641010Medicaid
MO20990132OtherBCBS NUMBER
KS101160440DMedicaid
KS207641044Medicaid
MO050063983OtherMO RR MEDICARE NUMBER
KS20990022OtherBCBS NUMBER
MO100160440BMedicaid
KSP00018703OtherKS RR MEDICARE NUMBER
MO20990132OtherBCBS NUMBER
KSE85280Medicare UPIN
MO207641010Medicaid
KS101160440DMedicaid