# CARONDELET PHYSICIAN SERVICES, INC

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

## Provider details

- **NPI number:** 1982018719
- **Legal business name:** CARONDELET HEALTH
- **Authorized official:** MR. STEVEN R CLEARY (VP/CFO)
- **Authorized official phone:** (816) 943-2819

## Contact information

- **Practice address:** 930 CARONDELET DR, SUITE 304, KANSAS CITY, MO 64114-4855
- **Practice address phone:** (816) 943-7777
- **Practice address fax:** (816) 943-7778
- **Mailing address:** 801 NW SAINT MARY DR, SUITE 230, BLUE SPRINGS, MO 64014-2524
- **Mailing address phone:** (816) 655-5791
- **Mailing address fax:** (816) 655-5457

## Taxonomy

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

## Other

- **Enumeration date:** 06/19/2014
- **Last updated:** 06/19/2014

## Other identifiers

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