Provider Demographics
NPI:1295704518
Name:INDEPENDENT ORTHOPAEDICS AND SPORTS MEDICINE OF KANSAS P A
Entity type:Organization
Organization Name:INDEPENDENT ORTHOPAEDICS AND SPORTS MEDICINE OF KANSAS P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIPPER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:816-221-2663
Mailing Address - Street 1:5140 NE ANTIOCH RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-2523
Mailing Address - Country:US
Mailing Address - Phone:816-221-2663
Mailing Address - Fax:
Practice Address - Street 1:5140 NE ANTIOCH RD
Practice Address - Street 2:SUITE B
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-2523
Practice Address - Country:US
Practice Address - Phone:816-221-2663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
N60000OtherPTAN
N604837Medicare ID - Type UnspecifiedPROVIDER NUMBER