Provider Demographics
NPI:1013132265
Name:FARRELL, DANIEL C (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:C
Last Name:FARRELL
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 1:12200 W 106TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2305
Mailing Address - Country:US
Mailing Address - Phone:913-541-8897
Mailing Address - Fax:913-541-7474
Practice Address - Street 1:12200 W 106TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2305
Practice Address - Country:US
Practice Address - Phone:913-541-8897
Practice Address - Fax:913-541-7474
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22624207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200579790AMedicaid
NE03158OtherBLUE CROSS OF NE
MO1013132265Medicaid
KSKA1290001Medicare PIN
KSP00691206Medicare PIN
P00237695Medicare ID - Type UnspecifiedRAILROAD MEDICARE
H71159Medicare UPIN
278214Medicare ID - Type Unspecified