# NOVAMED EYE SURGERY CENTER OF OVERLAND PARK, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Overland Park Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629078043
- **Authorized official:** JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
- **Authorized official phone:** (615) 234-5900

## Contact information

- **Practice address:** 5520 COLLEGE BLVD, SUITE 200, OVERLAND PARK, KS 66211-1630
- **Practice address phone:** (913) 491-3040
- **Practice address fax:** (913) 491-3640
- **Mailing address:** 5520 COLLEGE BLVD, SUITE 200, OVERLAND PARK, KS 66211-1630
- **Mailing address phone:** (913) 491-3040
- **Mailing address fax:** (913) 491-3640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | S-046-005 | KS | Yes |

## Other

- **Enumeration date:** 07/28/2005
- **Last updated:** 10/13/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100279090A | — | KS |
| 01 | — | 490003071 | RR MEDICARE | — |
| 05 | — | 508157302 | — | MO |