| NPI | 1215635875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY CLEMETSON Director Of Billing/Credentialing 913-475-7713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine |
| 207RB0002X Internal Medicine, Bariatric Medicine | |
| 207VB0002X Obstetrics & Gynecology, Bariatric Medicine | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 2084B0002X Psychiatry & Neurology, Bariatric Medicine | |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry | |
| 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| 202D00000X Integrative Medicine | |
| 207QA0505X Family Medicine, Adult Medicine | |
| Enumeration Date | 2023-02-22 |
| Last Update Date | 2024-01-16 |