Provider Demographics
NPI:1720069818
Name:LAMPE, GERALD N (PT PHD)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:N
Last Name:LAMPE
Suffix:
Gender:M
Credentials:PT PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20355 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MO
Mailing Address - Zip Code:64098-9251
Mailing Address - Country:US
Mailing Address - Phone:816-246-1456
Mailing Address - Fax:816-286-2774
Practice Address - Street 1:373 W 101ST TER
Practice Address - Street 2:SUITE 200
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114
Practice Address - Country:US
Practice Address - Phone:816-246-1456
Practice Address - Fax:816-286-2774
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00147225100000X
KS11-00260225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO02972046OtherBCBS
KS02972066OtherBCBS
MOMA1074001Medicare PIN
MO02972046OtherBCBS
MOMA1442001Medicare PIN
KS02972066OtherBCBS
MOMA1075001Medicare PIN