COLLEGE PARK ANCILLARY, LLC (NPI# 1508203241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508203241 |
| Entity Type | Organization |
| Organization Name | COLLEGE PARK ANCILLARY, LLC |
| Practice Address |
10600 Mastin St Overland Park KS 66212-5723 |
| Mailing Address |
11755 W 112th St Suite 202 Overland Park KS 66210-2742 |
| Practice Telephone | 9134380868 |
| Mailing Telephone | 9134690433 |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2013-06-04 |
| Authorized Official Name | TODD CARLON (VICE PRESIDENT) |
| Authorized Official Telephone | 8165084090 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356617757 | College Park Ancillary, LLC | Clinic/Center | 10600 Mastin St, Overland Park, KS 66212-5723 | 2012-03-29 |
| Street Address |
10600 MASTIN ST |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66212-5723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487657409 | Robert L Pierron | Orthopaedic Surgery | 10600 Mastin St, Overland Park, KS 66212-5723 | 2005-05-23 |
| 1821601931 | Katelyn Gibbons | Physical Therapist | 10600 Mastin St, Overland Park, KS 66212-5723 | 2020-08-28 |
| 1043850720 | Andrew Cozart | Physical Therapist | 10600 Mastin St, Overland Park, KS 66212-5723 | 2020-01-10 |
| 1659916963 | Olyvia Faith Engelhardt | Physical Therapy Assistant | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-11-11 |
| 1902440035 | Shane Marcus Wilson | Physical Therapy Assistant | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-11-01 |
| 1760026769 | Adrianna H Jensen | Physical Therapy Assistant | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-11-01 |
| 1497399406 | Elizabeth Anne Ashley | Physical Therapy Assistant | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-11-01 |
| 1437709615 | Lscm, LLC | Physical Therapist | 10600 Mastin St, Entrance B Attn: Shelley Lewis, Overland Park, KS 66212-5723 | 2019-09-19 |
| 1982266714 | Jacob C Crist | Physical Therapist | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-07-02 |
| 1669948618 | Brooke Katterhenry | Physical Therapist | 10600 Mastin St, Overland Park, KS 66212-5723 | 2018-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598363137 | Marva Calder | Nurse Practitioner | 7299 W 98th Terrance Bld 6, Suite 120, Overland Park, KS 66212 | 2020-10-15 |
| 1518572163 | Pathways To Empowerment | Marriage & Family Therapist | 7180 W. 107th Street, St. 21, Overland Park, KS 66212 | 2020-09-10 |
| 1689287914 | Lisa Marie Ambrosek | Behavioral Analyst | 7725 W 87th Street, Overland Park, KS 66212 | 2020-08-26 |
| 1598221061 | Ginger Marie Anderson | Massage Therapist | 9200 Glewood Street Suite 101, Overland Park, KS 66212 | 2019-02-20 |
| 1508335092 | Samantha Nicole Stevens | Behavior Technician | 7725 W. 87th Street, Overland Park, KS 66212 | 2018-11-14 |
| 1831600360 | Kristin Nichols | Occupational Therapist | 8826 Sante Fe Dr, Suite 203, Overland Park, KS 66212 | 2017-10-24 |
| 1538529003 | Cindy Sykes | Social Worker | 8402 Lowell Ave, Overland Park, KS 66212 | 2016-02-26 |
| 1265804157 | Lauren Spears | Psychologist | 10100 W 87th St Ste 306, Overland Park, KS 66212 | 2015-10-30 |
| 1699158279 | Harbor Hospice of Kansas Lp | Hospice Care, Community Based | 7223 W 95th St Ste 230, Overland Park, KS 66212 | 2015-07-01 |
| 1982000303 | Doolittle & Harrington Healthcare LLC | Clinic/Center | 10560 Barkley St Ste 340, Overland Park, KS 66212 | 2014-11-12 |
| Find all providers in zip 66212 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467920389 | Ku Medwest Ambulatory Surgery Center, LLC | Clinic/Center | 10720 Nall Avenue, Overland Park, KS 66211 | 2018-11-08 |
| 1043746555 | Overland Park Surgical Suites, LLC | Clinic/Center | 6650 W 110th St Ste 300, Overland Park, KS 66211 | 2017-05-03 |
| 1407294986 | Blue Valley Asc, P.a. | Clinic/Center | 12800 Metcalf Avenue Suite 2, Overland Park, KS 66213 | 2013-06-06 |
| 1104993385 | Surgery Center of Blue Valley, Inc | Clinic/Center | 7230 West 129th Street, Overland Park, KS 66213-2624 | 2006-11-30 |
| 1831283324 | Ambulatory Surgery Center of Kc, Inc | Clinic/Center | 9385 W. 75th St., Overland Park, KS 66204 | 2006-10-02 |
| 1659473924 | Mid-america Surgery Institute LLC | Clinic/Center | 5525 West 119th Street, Suite 100, Overland Park, KS 66209 | 2006-09-05 |
| 1528099207 | Deer Creek Surgery Center, LLC | Clinic/Center | 7220 W 129th Street, Overland Park, KS 66213 | 2006-07-05 |
| 1275596314 | Johnson County Surgery Center, L.p. | Clinic/Center | 8800 Ballentine St, Overland Park, KS 66214-1900 | 2006-04-10 |
| 1629510326 | College Park Endoscopy Center, LLC | Clinic/Center | 10787 Nall Ave, Suite 100, Overland Park, KS 66211-1375 | 2016-11-11 |
| 1215388632 | Motus Biologics and Sports Medicine LLC | Clinic/Center | 5525 W 119th St, Ste 250, Overland Park, KS 66209-3724 | 2016-06-27 |
| Find all providers in OVERLAND PARK | ||||
| City | OVERLAND PARK |
| Zip Code | 66212 |
Please comment or provide details below to improve the information on COLLEGE PARK ANCILLARY, LLC.
| 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.