AB JETMORE MD LLC (NPI# 1114258886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114258886 |
| Entity Type | Organization |
| Organization Name | AB JETMORE MD LLC |
| Practice Address |
21106 W 95th Ter Lenexa KS 66220-5600 |
| Mailing Address |
Po Box 7673 Overland Park KS 66207-0673 |
| Practice Telephone | 9133228859 |
| Practice Fax Number | 8887789471 |
| Mailing Telephone | 9133228859 |
| Mailing Fax Number | 8887789471 |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2010-12-23 |
| Authorized Official Name | DR. ALLEN BRUCE JETMORE (SOLE MEMBER) |
| Authorized Official Telephone | 9138297716 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208C00000X | Colon & Rectal Surgery | 04-24436 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | AETNA | 4221151 | 01 |
| MO | BLUE SHIELD KANSAS CITY | 42525017 | 01 |
| Street Address |
21106 W 95TH TER |
| City | LENEXA |
| State | KS |
| Zip Code | 66220-5600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162550 | Silverus Ngetich Kimeli | Nurse Practitioner | 22237 W 98th St, Lenexa, KS 66220 | 2020-07-24 |
| 1336420314 | Smiles of Kansas City Dental Center, P.a. | Dentist | 10127 Cherry #e, Lenexa, KS 66220 | 2011-09-02 |
| 1851615975 | Kansas Cvs Pharmacy, L.L.C. | Pharmacy | 10050 Woodland Rd, Lenexa, KS 66220 | 2010-03-18 |
| 1871705483 | Ryan Barrett Schell | Chiropractor | 10074 Woodland Rd, Lenexa, KS 66220 | 2007-05-04 |
| 1386607232 | Sean M Powell | Optometrist | 10123 Cherry Lane, Lenexa, KS 66220 | 2006-04-11 |
| 1295038453 | Kathleen Albert | Chiropractor | 10074 Woodland Rd, Lenexa, KS 66220 | 2010-12-09 |
| 1073899803 | Aceso Healthcare LLC | Home Health | 8928 Hirning Rd, Lenexa, KS 66220-2538 | 2011-10-25 |
| 1811154925 | Kc Baby Inc | Durable Medical Equipment & Medical Supplies | 20616 W 96th St, Lenexa, KS 66220-2658 | 2008-05-18 |
| 1063536936 | Stacy Rae Henn | Speech-Language Pathologist | 21609 W 98th Ter, Lenexa, KS 66220-2686 | 2007-03-18 |
| 1801371497 | Icare Transportation LLC | Non-emergency Medical Transport (VAN) | 21526 W 98th Ter, Lenexa, KS 66220-2687 | 2018-09-28 |
| Find all providers in zip 66220 | ||||
| Taxonomy Code | 208C00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Colon & Rectal Surgery |
| A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Colon and Rectal Surgery, 2007. http://www.abcrs.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Colon and Rectal Surgery. Colon and rectal surgeons have the expertise to diagnose and often manage anorectal conditions such as hemorrhoids, fissures (painful tears in the anal lining), abscesses and fistulae (infections located around the anus and rectum) in the office setting. They also treat problems of the intestine and colon, and perform endoscopic procedures to evaluate and treat problems such as cancer, polyps (precancerous growths) and inflammatory conditions. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689678096 | Pierre Castera | Colon & Rectal Surgery | 4370 W 109th St, Suite 350, Overland Park, KS 66211-1361 | 2005-06-13 |
| 1902095805 | Benyamine Mizrahi | Colon & Rectal Surgery | 4370 W 109th St, Suite 350, Overland Park, KS 66211-1361 | 2007-10-17 |
| 1053480897 | Colorectal Surgery Pa | Colon & Rectal Surgery | 8901 W 74th St, #148, Shawnee Mission, KS 66204 | 2006-11-07 |
| 1134212913 | Jeremy William Cravens | Colon & Rectal Surgery | 4370 W 109th St, Suite 350, Overland Park, KS 66211-1361 | 2006-10-02 |
| 1780797142 | Colon and Rectal Surgeons of Kc Pa | Colon & Rectal Surgery | 8901 W 74th St, Suite 149, Shawnee Mission, KS 66204-2204 | 2006-08-17 |
| 1477586030 | Midwest Surgical, P.a. | Colon & Rectal Surgery | 1431 Bluffview St Ste 210, Wichita, KS 67218-3039 | 2006-07-08 |
| 1861437386 | Noel Sanchez | Colon & Rectal Surgery | 1947 Founders St, Wichita, KS 67206-3548 | 2006-06-18 |
| 1225036767 | Michael G Porter | Colon & Rectal Surgery | 551 N Hillside St, Suite 550, Wichita, KS 67214-4923 | 2005-07-08 |
| 1649277443 | Justin A Reed | Colon & Rectal Surgery | 5500 E Kellogg Dr, Wichita, KS 67218-1607 | 2005-07-07 |
| 1730183120 | Colorectal Surgery Associates PC | Colon & Rectal Surgery | 4370 W 109th St, Suite 350, Overland Park, KS 66211-1361 | 2005-06-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.