Provider Demographics
NPI:1770536781
Name:ST. LUKE'S HOSPITAL
Entity type:Organization
Organization Name:ST. LUKE'S HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-932-6101
Mailing Address - Street 1:PO BOX 931634
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64193-0001
Mailing Address - Country:US
Mailing Address - Phone:816-461-8288
Mailing Address - Fax:816-461-6586
Practice Address - Street 1:4620 J C NICHOLS PKWY
Practice Address - Street 2:SUITE 405
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-1617
Practice Address - Country:US
Practice Address - Phone:816-960-0300
Practice Address - Fax:816-461-6586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOF060000Medicare ID - Type UnspecifiedGROUP #