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Contact Information

CENTERWELL SENIOR PRIMARY CARE (MO) PC
19401 E 39TH ST S
INDEPENDENCE, MO64057-2308
 Phone: 816-490-4277
 Fax: 855-446-7160
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
 

Non-Pharmacy Dispensing Site

332900000X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for CENTERWELL SENIOR PRIMARY CARE MO PC · (Female)

NPI Number 1649793001
Status Active
Credentials
Entity Individual
Enumeration date 07/18/2017
Last updated 01/24/2025 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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