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Organization

HEALTH ADMINISOURCE, L.L.C.

Active
Other names
Kansas City Physical Therapy Group
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELA A DUNCAN (ADMINISTRATOR)
(913) 384-5600
Entity
Organization

Contact information

Practice address
5799 BROADMOOR ST, STE 300, MISSION, KS 66202-2421
(913) 384-5600
Mailing address
5799 BROADMOOR ST, STE 300, MISSION, KS 66202-2421
(913) 384-5600

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14112990
U.S. DEPT OF LABOR
KS
01
14112991
U.S. DEPT OF LABOR
MO
01
16278037
BLUE CROSS BLUE SHIELD
01
4000127
MULTIPLAN PROVIDER NUMBER
01
440660
HEALTHLINK PROVIDER NUMBE
01
534021
BLUE CROSS BLUE SHIELD KS
KS
01
6400222
UNITED HEALTHCARE PROVIDE
01
731060
HEALTHCARE PREFERRED
01
8271336
AETNA PROVIDER NUMBER
01
T660000
MEDICARE PART B
KS
01
T660000A
MEDICARE PART B
MO
Enumeration date
06/01/2005
Last updated
11/26/2008
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