General Practice
PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1356683213 · enumerated 2013-03-19 · record updated 2025-08-25. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: CHRISTOPHER DOAN, Managing Associate General Counsel · (310) 259-4706
Other names: PROVIDENCE MEDICAL GROUP
Addresses and phones
- Practice location 16663 MIDLAND DR STE 100, SHAWNEE, KS, 66217-3042 (913) 631-2600 Fax (913) 631-2606 Google Maps Apple Maps OpenStreetMap
- Mailing address 8929 PARALLEL PKWY, KANSAS CITY, KS, 66112-1689 (913) 596-3930 Fax (913) 596-4098 Google Maps Apple Maps OpenStreetMap
Specialties
- Oral & Maxillofacial Surgery 204E00000X
- Anesthesiology 207L00000X
- Anesthesiology, Pain Medicine 207LP2900X
- Family Medicine 207Q00000X
- Internal Medicine 207R00000X
- Internal Medicine, Cardiovascular Disease 207RC0000X
- Internal Medicine, Gastroenterology 207RG0100X
- Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery 207VF0040X
- Orthopaedic Surgery 207X00000X
- Preventive Medicine, Undersea and Hyperbaric Medicine 2083P0011X
- Psychiatry & Neurology, Neurology 2084N0400X
- Surgery 208600000X
- Surgery, Pediatric Surgery 2086S0120X
- General Practice 208D00000X · Primary
In this directory
Locations and evidence
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Practice location
SHAWNEE, KS, 662173042
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.