OrganizationActive
Providence Care an Operating Division of Providence Medical Ctr
NPI 1700921970 · General Practice Physician · Bonner Springs, KS
Provider details
- NPI number
- 1700921970
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Providence Medical Center
- Organization subpart
- Yes
- Authorized official
- Randall Nyp, President/Ceo(913) 596-4000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
913 Sheidley Ave
Bonner Springs, KS 66012-9514
Phone: (913) 322-7222
Fax: (913) 322-7284
Street-level locationGet directions
Mailing address
Dept Ch 14363
Palatine, IL 60055-4363
Registry dates
- Enumerated
- 2007-02-21
- Last updated
- 2012-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.