Provider Demographics
NPI:1336251891
Name:MEARA, JOHN BRADLEY (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BRADLEY
Last Name:MEARA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2330 SHAWNEE MISSION PKWY
Mailing Address - Street 2:MEDICAL ADMINISTRATIVE SERVICES OF KU MED. STE 312
Mailing Address - City:WESTWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2005
Mailing Address - Country:US
Mailing Address - Phone:913-588-9000
Mailing Address - Fax:913-588-9822
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:PROFESSIONAL SERVICES OF KU HOSPITAL
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0001
Practice Address - Country:US
Practice Address - Phone:913-588-6504
Practice Address - Fax:913-588-9104
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-06-25
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Provider Licenses
StateLicense IDTaxonomies
MO2009033375207P00000X
KS04-27094207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100366390CMedicaid
10001758001OtherCHP PSKU
080175970OtherRR MEDICARE
481202402OtherPSKU TAX ID
MO202299129Medicaid
26732025OtherBCBS PROVIDER NUMBER
658471OtherFIRSTGUARD
7166132OtherAETNA