OrganizationActive
College Park Ancillary, LLC
NPI 1508203241 · Ambulatory Surgical Clinic/Center · Overland Park, KS
Provider details
- NPI number
- 1508203241
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Todd Carlon, Vice President(816) 508-4090
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
10600 Mastin St
Overland Park, KS 66212-5723
Phone: (913) 438-0868
Approximate (ZIP-level) locationGet directions
Mailing address
11755 W 112th St
Overland Park, KS 66210-2742
Registry dates
- Enumerated
- 2013-06-03
- Last updated
- 2013-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.