SIGNATURE MEDICAL GROUP OF KC PA (NPI# 1447708755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447708755 |
| Entity Type | Organization |
| Organization Name | SIGNATURE MEDICAL GROUP OF KC PA |
| Practice Address |
10777 Nall Ave Suite 300 Overland Park KS 66211-1362 |
| Practice Telephone | 9136420200 |
| Mailing Telephone | 9136420200 |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2016-09-15 |
| Authorized Official Name | TODD LAYTHAM (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 9135636630 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093265142 | Signature Medical Group of Kc Pa | Physician Assistant | 10777 Nall Ave, Suite 300, Overland Park, KS 66211-1362 | 2016-10-12 |
| Street Address |
10777 NALL AVE SUITE 300 |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66211-1362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922090794 | Gregory R Van Den Berghe | Orthopaedic Surgery | 10777 Nall Ave, Suite 300, Overland Park, KS 66211-1231 | 2005-08-18 |
| 1598260762 | Lindsey Michelle Brown | Nurse Practitioner | 10777 Nall Ave, Overland Park, KS 66211-1362 | 2018-03-28 |
| 1821536517 | Marsha L. Eck | Physical Therapist | 10777 Nall Ave, Suite 320, Overland Park, KS 66211-1362 | 2017-02-02 |
| 1750827986 | Kansas City Neurosurgery LLC | Neurological Surgery | 10777 Nall Ave, Suite 300, Overland Park, KS 66211-1362 | 2017-01-11 |
| 1124570080 | Signature Medical Group of Kc, Pa | Durable Medical Equipment & Medical Supplies | 10777 Nall Ave, Suite 300, Overland Park, KS 66211-1362 | 2016-10-26 |
| 1093265142 | Signature Medical Group of Kc Pa | Physician Assistant | 10777 Nall Ave, Suite 300, Overland Park, KS 66211-1362 | 2016-10-12 |
| 1669928438 | Caitlin Dotson | Physician Assistant | 10777 Nall Ave, Suite 300, Overland Park, KS 66211-1362 | 2016-08-31 |
| 1295188472 | Julie A. Alexander | Occupational Therapist | 10777 Nall Ave, Ste 300, Overland Park, KS 66211-1362 | 2016-07-22 |
| 1649696261 | Pinnacle Therapy Services LLC | Durable Medical Equipment & Medical Supplies | 10777 Nall Ave, Suite 320, Overland Park, KS 66211-1362 | 2014-03-06 |
| 1568801900 | Travis Scott Messer | Physical Therapist | 10777 Nall Ave, Suite 320 Corporate Medical Plaza Bldg II, Overland Park, KS 66211-1362 | 2013-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336611821 | Baillie Rose Woydziak | Social Worker | 5805 W 110th Street, Overland Park, KS 66211 | 2018-12-20 |
| 1467920389 | Ku Medwest Ambulatory Surgery Center, LLC | Clinic/Center | 10720 Nall Avenue, Overland Park, KS 66211 | 2018-11-08 |
| 1235615931 | Janice Carollo | Physical Therapy Assistant | 11611 Granada Lane, Leawood, KS 66211 | 2018-07-16 |
| 1720572555 | Trevor Lee Elmer | Physical Therapist | 10777 Nall, 320 - Corporate Medical Plaza Building II, Overland Park, KS 66211 | 2018-06-15 |
| 1043746555 | Overland Park Surgical Suites, LLC | Clinic/Center | 6650 W 110th St Ste 300, Overland Park, KS 66211 | 2017-05-03 |
| 1619313665 | Vcphcs Xiv, LLC | Clinic/Center | 6331 W. 110th Street, Overland Park, KS 66211 | 2013-05-17 |
| 1528334950 | Scott Anthony Hardouin | Surgery | 5100 W 110th St Unit 300, Overland Park, KS 66211 | 2012-03-29 |
| 1386917003 | Children's Physical Therapy Associates | Physical Therapist | 6600 College Boulevard, Suite 307, Overland Park, KS 66211 | 2012-02-10 |
| 1871876250 | Amber Diane Dalzell | Social Worker | 10965 Granada Ln Ste 102, Overland Park, KS 66211 | 2011-09-22 |
| 1912298001 | Stephen Vincent Hiatt | Orthopaedic Surgery | 10701 Nall Avenue, Suite 200, Overland Park, KS 66211 | 2011-04-25 |
| Find all providers in zip 66211 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922070101 | Robert Troy Stucker | Physician Assistant | 10701 Nall Ave, Suite 200, Overland Park, KS 66211-1231 | 2006-02-02 |
| 1225661317 | Surgikal Services | Physician Assistant | 10500 Quivira Rd, Overland Park, KS 66215-2306 | 2020-02-17 |
| 1265802284 | Rachel Miles | Physician Assistant | 12200 W 106th St Ste 400, Overland Park, KS 66215-2305 | 2015-10-02 |
| 1689003345 | Holly C Bachman | Physician Assistant | 10787 Nall Ave, Suite 220, Overland Park, KS 66211-1375 | 2013-11-04 |
| 1336420561 | Shannon K Hailey | Physician Assistant | 10777 Nall Ave Ste 300, Overland Park, KS 66211-1330 | 2011-09-01 |
| 1740216522 | Derek W Barnard | Physician Assistant | 5525 W 119th St, Suite 210, Overland Park, KS 66209-3718 | 2006-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675725 | Jordan Levi Walter | Physician Assistant | Associated Urologsits P A, 1133 College Ave G100, Manhattan, KS 66502-2756 | 2019-05-29 |
| 1316217102 | Tina L Lee | Physician Assistant | 15263 Sweetbriar Dr, Basehor, KS 66007-3031 | 2012-01-10 |
| 1407098395 | Kara Leigh-lawless Boyd | Physician Assistant | 3651 College Boulevard, Leawood, KS 66211 | 2009-03-24 |
| 1053446708 | Eastern Surgical Assistants, LLC | Physician Assistant | 16427 Metro Ave, Bonner Springs, KS 66012-7108 | 2007-02-22 |
| 1730223785 | Ty M. Taylor | Physician Assistant | 8321 Alden St, Lenexa, KS 66215-4213 | 2007-02-16 |
| 1366457038 | Gustav Thomas Riemer | Physician Assistant | 9119 W. 74th Street, Suite 354, Shawnee Mission Medical Building, Merriam, KS 66204 | 2006-07-30 |
| 1699795112 | Kenneth Brian Filsinger | Physician Assistant | 1112 W 6th St Ste 124, Lawrence, KS 66044-2249 | 2006-07-20 |
| 1962435552 | Gregory Bryan De Laney | Physician Assistant | 1431 Bluffview St Ste 210, Wichita, KS 67218-3039 | 2006-07-08 |
| 1538122973 | Leah Alpers | Physician Assistant | 351 W 10th St, Hoisington, KS 67544-1715 | 2006-04-07 |
| 1275596611 | Anne Linenberger | Physician Assistant | 1514 K 96 Highway, Great Bend, KS 67530 | 2006-04-07 |
| Find all providers with the same taxonomy | ||||
| City | OVERLAND PARK |
| Zip Code | 66211 |
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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.