Provider Demographics
NPI:1952357360
Name:KATS, SOPHIA (NP)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:KATS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:
Other - Last Name:GRIMBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:816-502-7117
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:4330 WORNALL RD
Practice Address - Street 2:SUITE 2000
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5939
Practice Address - Country:US
Practice Address - Phone:816-931-1883
Practice Address - Fax:816-756-3645
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45401363L00000X
MO2002028631363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100450470DMedicaid
KSP00842729OtherRAILROAD MEDICARE
KS100450470FMedicaid
MOP00836081OtherRAILROAD MEDICARE
MO428419816Medicaid
KS100450470GMedicaid
P82446Medicare UPIN
KS100450470FMedicaid
KSP00842729OtherRAILROAD MEDICARE
KS100450470DMedicaid
MOMA2491012Medicare PIN