PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1356683213, based in Shawnee, KS. The organization lists 14 taxonomy classifications, with General Practice Physician recorded as primary.
Getting there
The practice address on file is 16663 MIDLAND DR STE 100, Shawnee, KS 66217. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
NPPES does not list a state licence number for this record. That is not unusual — organizations and some provider types are not required to file one. Verify current licensure with the relevant state board before care.
- Status
- Approved
- Provider type
- Part B Supplier - Clinic/group Practice
- PAC ID
- 1052553906
- Enrollment ID
- O20130806000598
Medicare enrolment is recorded as approved under the provider type Part B Supplier - Clinic/group Practice. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What General Practice covers
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. NUCC Health Care Provider Taxonomy, code 208D00000X
All registered taxonomy codes
This provider registers 14 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 208D00000X | General Practice Physician | — | — | primary |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | |
| 207L00000X | Anesthesiology Physician | — | — | |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician Pain Medicine | — | — | |
| 207Q00000X | Family Medicine Physician | — | — | |
| 207R00000X | Internal Medicine Physician | — | — | |
| 207RC0000X | Cardiovascular Disease Physician Cardiovascular Disease | — | — | |
| 207RG0100X | Gastroenterology Physician Gastroenterology | — | — | |
| 207VF0040X | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician Urogynecology and Reconstructive Pelvic Surgery | — | — | |
| 207X00000X | Orthopaedic Surgery Physician | — | — | |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician Undersea and Hyperbaric Medicine | — | — | |
| 2084N0400X | Neurology Physician Neurology | — | — | |
| 208600000X | Surgery Physician | — | — | |
| 2086S0120X | Pediatric Surgery Physician Pediatric Surgery | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1356683213 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Mar 19, 2013 |
| Last updated | Aug 25, 2025 |
| Status | Active |
| Practice address |
16663 MIDLAND DR STE 100 Shawnee, KS 66217 (913) 631-2600 Fax (913) 631-2606 |
| Mailing address |
8929 PARALLEL PKWY Kansas City, KS 66112 |
| Other identifiers |
201193920H
· Medicaid (KS) 500017218 · Medicaid (MO) |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 3 | 5 | 6 | 6 | 8 | 3 | 2 | 1 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 3 | 1 | 6 | 3 | 8 | 6 | 2 | 2 |
Sum = 57 · next multiple of 10 = 60 · check digit = 3 · actual last digit = 3
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.