Provider Demographics
NPI:1205902921
Name:CLINICAL CARDIOVASCULAR ASSOCIATES, P.A.
Entity type:Organization
Organization Name:CLINICAL CARDIOVASCULAR ASSOCIATES, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-381-7117
Mailing Address - Street 1:PO BOX 8709
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-0709
Mailing Address - Country:US
Mailing Address - Phone:913-381-7117
Mailing Address - Fax:913-383-1316
Practice Address - Street 1:19550 E 39TH ST S
Practice Address - Street 2:SUITE 227
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-2303
Practice Address - Country:US
Practice Address - Phone:816-795-9716
Practice Address - Fax:816-795-6358
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CLINICAL CARDIOVASCULAR ASSOCIATES, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-27
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100214200CMedicaid
MO501733927Medicaid
MOCJ2658Medicare PIN
KSCU0649Medicare PIN
MO501733927Medicaid
MO6470000Medicare PIN