Provider Demographics
NPI:1255424628
Name:KANSAS PULMONARY AND SLEEP SPECIALISTS CHARTERED
Entity type:Organization
Organization Name:KANSAS PULMONARY AND SLEEP SPECIALISTS CHARTERED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-599-3800
Mailing Address - Street 1:PO BOX 12035
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-0035
Mailing Address - Country:US
Mailing Address - Phone:913-599-3800
Mailing Address - Fax:913-599-3854
Practice Address - Street 1:10550 QUIVIRA RD
Practice Address - Street 2:SUITE 480
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2306
Practice Address - Country:US
Practice Address - Phone:913-599-3800
Practice Address - Fax:913-599-3854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO507712206Medicaid
KS110575OtherBCBS KANSAS
KS2053519301Medicaid
26005013OtherBCBS KANSAS CITY
KS110575OtherBCBS KANSAS
CS8800Medicare ID - Type UnspecifiedRAILROAD
MO507712206Medicaid