PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC – NPI #1972119741
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Health Care Provider Taxonomy Code for General Practice

PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC is a provider located in LEAVENWORTH, KS. NPPES has assigned the NPI number 1972119741 to PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC on September 17, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

The NPI profile was last updated on Aug 25, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC below.

NPI Profile for
PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC

NPI Number
1972119741
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC
Primary location
3550 S 4TH ST STE 100
LEAVENWORTH, KS 66048-5061
Phone: (913) 680-6200 Fax: (913) 680-6348
Mailing address
1000 CARONDELET DR
PHYSICIAN BILLING OFFICE
KANSAS CITY, MO 64114
Phone: (816) 943-2283 Fax: (816) 943-5762
Organization Subpart
Yes - PRIME HEALTHCARE PHYSICIAN SERVICES - PROVIDENCE INC is subpart of another organization.
Authorized Official
DAVID DULNY
PROVIDENCE CFO
Phone: (913) 596-4835
Updated
Certification Date
Aug 25, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.