Provider Demographics
NPI:1013901404
Name:MIDWEST HOSPITAL SPECIALISTS, P.A.
Entity type:Organization
Organization Name:MIDWEST HOSPITAL SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-660-1616
Mailing Address - Street 1:10901 GRANADA LN
Mailing Address - Street 2:STE. 200
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1401
Mailing Address - Country:US
Mailing Address - Phone:913-660-1616
Mailing Address - Fax:913-660-1664
Practice Address - Street 1:10901 GRANADA LN
Practice Address - Street 2:STE. 200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1401
Practice Address - Country:US
Practice Address - Phone:913-660-1616
Practice Address - Fax:913-660-1664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100357430AMedicaid
177826002OtherOWCP DEEOIC DOL
MO504676008Medicaid
KSDB3032OtherRR MCR
KS100357430BMedicaid
177826001OtherDOL FECA
24826016OtherBCBS
MOCG6035OtherRR MCR
KS100357430AMedicaid
MOCG6035OtherRR MCR
KSI140000Medicare PIN