CARONDELET PHYSICIAN SERVICES INC (NPI# 1467758144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467758144 |
| Entity Type | Organization |
| Organization Name | CARONDELET PHYSICIAN SERVICES INC |
| Other Organization Name | FAMILY MEDICAL CARE ASSOCIATES |
| Practice Address |
100 Nw Mock Ave Suite 200 Blue Springs MO 64014-2501 |
| Mailing Address |
801 Nw Saint Mary Dr Suite 230 Blue Springs MO 64014-2524 |
| Practice Telephone | 8162281000 |
| Practice Fax Number | 8164636035 |
| Mailing Telephone | 8166555792 |
| Mailing Fax Number | 8166555787 |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2011-05-06 |
| Authorized Official Name | MR. STEVEN R CLEARY (VP/CFO) |
| Authorized Official Telephone | 8169432819 |
| Is Organization Subpart | Y |
| Parent Organization Name | CARONDELET HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | R3D26 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 501269500 | 05 | |
| BCBS OF KANSAS CITY | 39532013 | 01 |
| Other Name | Type Code |
|---|---|
| Family Medical Care Associates | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811293582 | Carondelet Physician Services Inc | Family Medicine | 1900 S Broadway, Oak Grove, MO 64075-9020 | 2011-01-28 |
| 1427220375 | Carondelet Physician Services Inc | Orthopaedic Surgery | 300 Nw Mock Ave, Suite 200, Blue Springs, MO 64014-2543 | 2008-04-01 |
| Street Address |
100 NW MOCK AVE SUITE 200 |
| City | BLUE SPRINGS |
| State | MO |
| Zip Code | 64014-2501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144221029 | Eliska C Webster | Specialist | 100 Nw Mock Ave, Ste 200, Blue Springs, MO 64014 | 2005-08-02 |
| 1134685258 | Elizabeth Gatrost | Nurse Practitioner | 100 Nw Mock Ave, Ste 200, Blue Springs, MO 64014 | 2019-02-13 |
| 1831591684 | Jacqueline D Tebeest | Nurse Practitioner | 100 Nw Mock Ave, Ste 200, Blue Springs, MO 64014-2524 | 2014-09-24 |
| 1720355159 | J Anthony Woltjen, Md, PC | Specialist | 100 Nw Mock Ave, Suite 101, Blue Springs, MO 64014-2501 | 2011-11-30 |
| 1780612788 | Family Medical Care Associates PC | Family Medicine | 100 Nw Mock Ave, Suite 200, Blue Springs, MO 64014 | 2006-06-29 |
| 1699721951 | Cedar Creek Medical Group LLC | Internal Medicine | 100 Nw Mock Ave, Blue Springs, MO 64014-2501 | 2006-05-26 |
| 1427042068 | John Anthony Woltjen | Internal Medicine | 100 Nw Mock Ave, Suite 101, Blue Springs, MO 64014-2501 | 2005-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437756319 | Ltaj Properties LLC | Physical Therapist | 514 Nw State 7 Hwy, Suite A, Blue Springs, MO 64014 | 2020-10-05 |
| 1790397198 | Miranda Bramble | Pharmacist | 1701 Nw Highway 7, Blue Springs, MO 64014 | 2020-08-18 |
| 1659915098 | Cheif Smiles LLC | Dentist | 620 E. Us Highway 40, Blue Springs, MO 64014 | 2019-10-29 |
| 1629637764 | Beau Devereux Butzirus | Dentist | 1125 South Mo-7, Blue Springs, MO 64014 | 2019-06-12 |
| 1245725605 | Brian Geraghty | Orthopaedic Surgery | 201 Nw R D Mize Road, Blue Springs, MO 64014 | 2018-06-28 |
| 1588101224 | Andy Anderson | Prevention Professional | 2705 Nw 3rd Ter, Blue Springs, MO 64014 | 2017-01-19 |
| 1801250469 | Louis Spear | Dentist | 1215 A Nw 7 Highway, Blue Springs, MO 64014 | 2016-04-11 |
| 1083027411 | Alex Sharifian Dds Blue Springs Dentistry PC | Dentist | 1205 Ne Coronado Drive, Blue Springs, MO 64014 | 2014-06-03 |
| 1730512336 | Valerie Fombon | Pharmacist | 625 W 40 Hwy, Blue Springs, MO 64014 | 2013-08-19 |
| 1356692750 | Central Jackson County Fire Protection District | Ambulance | 805 Ne Jefferson St, Blue Springs, MO 64014 | 2012-09-25 |
| Find all providers in zip 64014 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255816591 | Takedria Mingo-berry | Family Medicine | 206 Nw Mock Ave Ste 201, Blue Springs, MO 64014-2530 | 2018-10-02 |
| 1235251562 | Leigh Gilburn | Family Medicine | 5435 Sw Us Highway 40, Blue Springs, MO 64015 | 2007-04-06 |
| 1558495812 | Woods Chapel Medical Group PC | Family Medicine | 1523 Sw 7 Hwy, Blue Springs, MO 64015 | 2007-03-16 |
| 1811060767 | Blue Springs Family Care PC | Family Medicine | 104 N. 7 Highway, Suite B, Blue Springs, MO 64014-7276 | 2006-11-16 |
| 1710056411 | Dorland Alfred Deshong | Family Medicine | 1208 Nw 6th Terrace, Blue Springs, MO 64014-2200 | 2006-11-07 |
| 1346253580 | Jon Robert Mattson | Family Medicine | 3308 Thornbird St, Blue Springs, MO 64015-9644 | 2006-08-15 |
| 1275549974 | Theresa C Garcia | Family Medicine | 1416 Nw State Route 7, Blue Springs, MO 64014-2238 | 2006-08-01 |
| 1326094632 | Family Care of E. Jackson County LLC | Family Medicine | 725 Nw State Route 7 Ste B, Blue Springs, MO 64014-2426 | 2006-05-26 |
| 1750345245 | Tara A Clark | Family Medicine | 600 Ne Adams Dairy Pkwy, Blue Springs, MO 64014-5493 | 2006-04-13 |
| 1205896685 | Russell Jay Thornton | Family Medicine | 1700 Nw Mock Ave, Blue Springs, MO 64015-3118 | 2006-03-28 |
| Find all providers in BLUE SPRINGS | ||||
| City | BLUE SPRINGS |
| Zip Code | 64014 |
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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.