Basic Information
| Provider Information | |||||||||
| NPI: | 1053581827 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHEFFLER | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | P.A. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | KASCHALK | ||||||||
| OtherFirstName: | SUSAN | ||||||||
| OtherMiddleName: | M | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | P.A. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 10701 NALL AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662111231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133815225 | ||||||||
| FaxNumber: | 9139010186 | ||||||||
| Practice Location | |||||||||
| Address1: | 10701 NALL AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662111231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133815225 | ||||||||
| FaxNumber: | 9139010186 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2008 | ||||||||
| LastUpdateDate: | 11/06/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 15-01232 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 2008012518 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | P00616075 | 01 | KS | RR MEDICARE | OTHER | 39907018 | 01 | KS | BCBS | OTHER |