John David Mandeville (NPI# 1306017959, PAC ID# 9830318021) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1306017959 |
| PAC ID by PECOS | 9830318021 |
| Professional Enrollment ID | I20190118002400 |
| Full Name | John David Mandeville |
| Organization Legal Name | SOUTHWEST BOULEVARD FAMILY HEALTH CARE SERVICES OF GREATER KANSAS CITY |
| Address |
340 Southwest Blvd Kansas City KS 66103-2150 |
| Phone Number | 9137223100 |
| Gender | M |
| Medical School | NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY |
| Graduation Year | 2007 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 8325115223 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 170040 | UNIVERSITY OF KANSAS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 340 Southwest Blvd, Kansas City, KS 66103-2150 | 9137223100 | SOUTHWEST BOULEVARD FAMILY HEALTH CARE SERVICES OF GREATER KANSAS CITY |
| Organization Legal Name | SOUTHWEST BOULEVARD FAMILY HEALTH CARE SERVICES OF GREATER KANSAS CITY |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joy L Durham | Clinical Social Worker | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Sharon D Lee | Family Medicine | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Stella L Ngetich | Nurse Practitioner | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Christine Louise Lightfoot | Nurse Practitioner | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Kathryn D Thiessen | Nurse Practitioner | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Brittany Simpson | Nurse Practitioner | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Lindsay C Mccrite | Physician Assistant | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Jaynell Assmann | Nurse Practitioner | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Street Address |
340 SOUTHWEST BLVD |
| City | KANSAS CITY |
| State | KS |
| Zip | 66103-2150 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joy L Durham | Clinical Social Worker | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Sharon D Lee | Family Medicine | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Stella L Ngetich | Nurse Practitioner | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Christine Louise Lightfoot | Nurse Practitioner | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Kathryn D Thiessen | Nurse Practitioner | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Brittany Simpson | Nurse Practitioner | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Lindsay C Mccrite | Physician Assistant | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Jaynell Assmann | Nurse Practitioner | Southwest Boulevard Family Health Care Services of Greater Kansas City | 340 Southwest Blvd, Kansas City, KS 66103-2150 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark T Cunningham | Pathology | Kansas University Physicians Inc | 3599 Rainbow Blvd, Kansas City, KS 66103-2078 |
| Richard J Barohn | Neurology | Kansas University Physicians Inc | 3599 Rainbow Blvd, Kansas City, KS 66103-2078 |
| Michael A Rippee | Neurology | Kansas University Physicians Inc | 3599 Rainbow Blvd, Kansas City, KS 66103-2078 |
| Tahira Zufer | Family Medicine | Kansas University Physicians Inc | 3599 Rainbow Blvd, Kansas City, KS 66103-2078 |
| Timothy A Fields | Pathology | Kansas University Physicians Inc | 3599 Rainbow Blvd, Kansas City, KS 66103-2078 |
| Kathrin Rose Husmann | Neurology | Kansas University Physicians Inc | 3599 Rainbow Blvd, Kansas City, KS 66103-2078 |
| Richard M Dubinsky | Neurology | Kansas University Physicians Inc | 3599 Rainbow Blvd, Kansas City, KS 66103-2078 |
| James Theodore Birch Jr. | Geriatric Medicine | Kansas University Physicians Inc | 3599 Rainbow Blvd, Kansas City, KS 66103-2078 |
| Rajesh Pahwa | Neurology | Kansas University Physicians Inc | 3599 Rainbow Blvd, Kansas City, KS 66103-2078 |
| Deon Cox Hayley | Geriatric Medicine | Kansas University Physicians Inc | 3599 Rainbow Blvd, Kansas City, KS 66103-2078 |
| Find all physicians in zip 66103 | |||
| City | KANSAS CITY |
| Zip Code | 66103 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | KANSAS CITY + FAMILY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.