IndividualActive
Mark Pemberton, PAC
NPI 1669433652 · Surgical Physician Assistant · Shawnee Mission, KS
Provider details
- NPI number
- 1669433652
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PAC
- Sex
- Male
- Sole proprietor
- No
- License
- 1500212 (KS)
Practice location
7450 Kessler St Ste 202
Shawnee Mission, KS 66204-2553
Phone: (913) 632-9480
Fax: (913) 632-9499
Mailing address
7450 Kessler St Ste 202
Shawnee Mission, KS 66204-2553
Registry dates
- Enumerated
- 2006-03-29
- Last updated
- 2025-03-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.