Prime Healthcare Physician Services - Providence Inc
NPI 1356683213 · General Practice Physician · Shawnee, KS
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Prime Healthcare Physician Services - Providence Inc is a General Practice Physician organization in Shawnee, KS (NPI 1356683213).
Provider details
- NPI number
- 1356683213
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Prime Healthcare Services, Inc
- Organization subpart
- Yes
- Authorized official
- Christopher Doan, Managing Associate General Counsel(310) 259-4706
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Oral & Maxillofacial Surgery (D.M.D.)204E00000X
Allopathic & Osteopathic Physicians
- Anesthesiology Physician207L00000X
Allopathic & Osteopathic Physicians
- Pain Medicine (Anesthesiology) Physician207LP2900X
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Cardiovascular Disease Physician207RC0000X
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
19 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Providence Medical Group
Additional practice locations (18)
- 15604 Pinehurst Dr Ste 2Basehor, KS 66007-8234Phone: (913) 728-2200
- 913 Sheidley AveBonner Springs, KS 66012-9514Phone: (913) 322-7222
- 8919 Parallel Pkwy Ste 440Kansas City, KS 66112-1655Phone: (913) 596-7286
- 8919 Parallel Pkwy Ste 416Kansas City, KS 66112-1655Phone: (913) 596-5104
- 1420 S 42nd StKansas City, KS 66106-1952Phone: (913) 831-1100
- 8929 Parallel PkwyKansas City, KS 66112-1689Phone: (913) 596-3930Fax: (913) 596-4098
- 8919 Parallel Pkwy Ste 580Kansas City, KS 66112-1655Phone: (913) 596-7224
- 8919 Parallel Pkwy Ste 121Kansas City, KS 66112-1655Phone: (913) 596-7230Fax: (913) 596-7228
- 8919 Parallel Pkwy Ste 206Kansas City, KS 66112-1655
Registry dates
- Enumerated
- 2013-03-19
- Last updated
- 2025-08-25
- Certified
- 2025-08-25
Frequently asked questions
- What is Prime Healthcare Physician Services - Providence Inc's NPI number?
- Prime Healthcare Physician Services - Providence Inc's National Provider Identifier (NPI) is 1356683213, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Prime Healthcare Physician Services - Providence Inc?
- Prime Healthcare Physician Services - Providence Inc is classified in the NPPES registry as General Practice Physician (Allopathic & Osteopathic Physicians).
- Where is Prime Healthcare Physician Services - Providence Inc located?
- Prime Healthcare Physician Services - Providence Inc's practice location on file with NPPES is 16663 Midland Dr Ste 100, Shawnee, KS 66217-3042.
- What is Prime Healthcare Physician Services - Providence Inc's phone number?
- The practice phone number listed in the NPPES registry for Prime Healthcare Physician Services - Providence Inc is (913) 631-2600.
- Does Prime Healthcare Physician Services - Providence Inc accept Medicare?
- Prime Healthcare Physician Services - Providence Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Prime Healthcare Physician Services - Providence Inc?
- The authorized official listed on Prime Healthcare Physician Services - Providence Inc's NPPES record is Christopher Doan, Managing Associate General Counsel. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Prime Healthcare Physician Services - Providence Inc's NPI active?
- Yes — Prime Healthcare Physician Services - Providence Inc's NPI (1356683213) is active in the NPPES registry as of the last update on 2025-08-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.