SKIN & MOHS SURGERY CENTER, LLC (NPI# 1669577524) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669577524 |
| Entity Type | Organization |
| Organization Name | SKIN & MOHS SURGERY CENTER, LLC |
| Practice Address |
11550 Granada St Leawood KS 66211-1453 |
| Practice Telephone | 9134517546 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2014-06-18 |
| Authorized Official Name | DR. GLENN D GOLDSTEIN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9134517546 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | OLIVER STREET DERMATOLOGY HOLDINGS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
S046023 | KS | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881875227 | Skin & Mohs Surgery Center, LLC | Clinic/Center | 3265 Ne Ralph Powell Rd, Lees Summit, MO 64064-2301 | 2007-11-14 |
| Street Address |
11550 GRANADA ST |
| City | LEAWOOD |
| State | KS |
| Zip Code | 66211-1453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588665509 | Elizabeth A Spenceri | Dermatology | 11550 Granada St, Leawood, KS 66211-1453 | 2005-08-02 |
| 1750655585 | Anne M Blake | Dermatology | 11550 Granada St, Leawood, KS 66211-1453 | 2012-02-24 |
| 1174722292 | Colin A Ruff | Dermatology | 11550 Granada St, Leawood, KS 66211-1453 | 2007-07-18 |
| 1568669794 | Celeste A Angel | Dermatology | 11550 Granada St, Leawood, KS 66211-1453 | 2007-06-29 |
| 1326090259 | Daniel P Bortnick | Plastic Surgery | 11550 Granada St, Leawood, KS 66211-1453 | 2006-05-17 |
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689173981 | Mao Leawood Surgery Center LLC | Clinic/Center | 4940 W 137th Street, Leawood, KS 66224 | 2018-02-02 |
| 1740794973 | Epic Asc, LLC | Clinic/Center | 11261 Nall Ave Ste 200, Leawood, KS 66211-1669 | 2017-11-27 |
| 1437237401 | Surgery Center of Leawood, LLC | Clinic/Center | 11413 Ash St Ste 100, Leawood, KS 66211-1692 | 2006-11-01 |
| 1942437504 | Epic Surgery Centers, LLC | Clinic/Center | 11261 Nall Ave, Suite 200, Leawood, KS 66211-1676 | 2009-06-22 |
| 1871586149 | Discover Vision Surgery & Laser Center LLC | Clinic/Center | 11500 Granada St, Leawood, KS 66211-1453 | 2005-08-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760020846 | Founders Surgery Center, LLC | Clinic/Center | 1961 N Founders Circle, Wichita, KS 67206 | 2019-12-19 |
| 1770147217 | Andover Ambulatory Surgery Center, LLC | Clinic/Center | 1124 W 21st St Ste 100, Andover, KS 67002-5500 | 2019-04-30 |
| 1255896676 | Ascentist Asc Merriam, LLC | Clinic/Center | 6815 Frontage Rd Ste B, Merriam, KS 66204-1291 | 2019-02-11 |
| 1467920389 | Ku Medwest Ambulatory Surgery Center, LLC | Clinic/Center | 10720 Nall Avenue, Overland Park, KS 66211 | 2018-11-08 |
| 1396238010 | Wichita Nephrology Group, Pa | Clinic/Center | 2122 N Garnett St, Wichita, KS 67206-3023 | 2018-06-07 |
| 1801323191 | Ns Surgical Center LLC | Clinic/Center | 10 E Cambridge Circle Dr Ste 150, Kansas City, KS 66103-1393 | 2017-05-17 |
| 1043746555 | Overland Park Surgical Suites, LLC | Clinic/Center | 6650 W 110th St Ste 300, Overland Park, KS 66211 | 2017-05-03 |
| 1316470354 | Manhattan Specialists Center LLC | Clinic/Center | 202 Research Dr, Manhattan, KS 66503-3049 | 2017-04-06 |
| 1942748793 | Rock Surgery Center, LLC | Clinic/Center | 1101 N. Rock Rd., Bldg 2, Derby, KS 67037-3750 | 2017-02-01 |
| 1457757346 | South Wind Women's Centter, LLC | Clinic/Center | 5701 E Kellogg Drive, Wichita, KS 67218 | 2014-11-05 |
| 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.