Organization
KC PODIATRY CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAPHAEL NGUYEN NGUYEN DPM (PRESIDENT)
(913) 432-2000
Entity
Organization
Contact information
Practice address
7301 MISSION RD, SUITE 152, PRAIRIE VILLAGE, KS 66208-3006
(913) 432-2000
(913) 432-2001
Mailing address
7301 MISSION RD, SUITE 152, PRAIRIE VILLAGE, KS 66208-3006
(913) 432-2000
(913) 432-2001
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
12-00309
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114130
MEDICARE PROVIDER GROUP # FOR KS (OUTSIDE KANSAS CITY LIMITS)
KS
01
—
26580022
BCBS
KS
01
—
KA2540
PTAN (FOR JOHNSON COUNTY AREA)
KS
01
—
KA2541
PTAN (FOR OUTSIDE OF KANSAS CITY/JOHNSON CO AREAS)
KS
01
—
P00183110
MEDICARE RAILROAD
KS
01
—
S340000
MEDICARE PROVIDER GROUP #
KS
Enumeration date
03/07/2012
Last updated
05/24/2012
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