# CARONDELET PHYSICIAN SERVICES INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CARONDELET HEALTH
- **Other names:** Family Medical Care Associates
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1467758144
- **Legal business name:** CARONDELET HEALTH
- **Authorized official:** MR. STEVEN R CLEARY (VP/CFO)
- **Authorized official phone:** (816) 943-2819

## Contact information

- **Practice address:** 100 NW MOCK AVE, SUITE 200, BLUE SPRINGS, MO 64014-2501
- **Practice address phone:** (816) 228-1000
- **Practice address fax:** (816) 463-6035
- **Mailing address:** 801 NW SAINT MARY DR, SUITE 230, BLUE SPRINGS, MO 64014-2524
- **Mailing address phone:** (816) 655-5792
- **Mailing address fax:** (816) 655-5787

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | R3D26 | MO | Yes |

## Other

- **Enumeration date:** 01/28/2011
- **Last updated:** 05/06/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 39532013 | BCBS OF KANSAS CITY | — |
| 05 | — | 501269500 | — | MO |