Basic Information
| Provider Information | |||||||||
| NPI: | 1295378156 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | KANSAS UNIVERSITY PHYSICIANS, INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| OtherOrganizationName: | SPRINT CENTER URGENT CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11300 CORPORATE AVE STE 330 | ||||||||
| Address2: | |||||||||
| City: | LENEXA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662191355 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135886111 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4000 CAMBRIDGE ST | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | KS | ||||||||
| PostalCode: | 661608501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135881227 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2019 | ||||||||
| LastUpdateDate: | 10/31/2019 | ||||||||
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| AuthorizedOfficialLastName: | STUDNICKA | ||||||||
| AuthorizedOfficialFirstName: | RETA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | COMPLIANCE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 9135886629 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | KANSAS UNIVERSITY HEALTH AUTHORITY | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.