Provider Demographics
NPI:1902871353
Name:GROWNEY, JOHN T (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:GROWNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:T
Other - Last Name:GROWNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:801 ATCHISON ST
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-2352
Mailing Address - Country:US
Mailing Address - Phone:913-367-5020
Mailing Address - Fax:913-367-1089
Practice Address - Street 1:801 ATCHISON ST
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-2352
Practice Address - Country:US
Practice Address - Phone:913-367-5020
Practice Address - Fax:913-367-1089
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2020-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-15196207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
46144861OtherAETNA
KS460484OtherCHILDRENS MERCY FAMILY HEALTH PARTNERS
KS6365OtherUNICARE
0188344OtherUNITED HEALTHCARE
KS0600409OtherTRIWEST
KS100087100AMedicaid
KS106418OtherBLUE CROSS BLUE SHIELD
KS011077482OtherRAILROAD MEDICARE
MO05635019OtherBLUE CROSS BLUE SHIELD OF KANSAS CITY INDIVIDUAL NUMBER
KS111327OtherBLUE CROSS BLUE SHIELD OF KANSAS
KS106418OtherBLUE CROSS BLUE SHIELD OF KANSAS GROUP NUMBER
MO05634011OtherBLUE CROSS BLUE SHIELD OF KANSAS CITY GROUP NUMBER
MO10001214400OtherCOMMUNITY HEALTH PLAN
132942OtherHEALTHLINK
KS111327OtherBLUE CROSS BLUE SHIELD OF KANSAS
KSD17383Medicare UPIN