Provider Demographics
NPI:1063199685
Name:SPIRA INNOVATIONS, LLC.
Entity type:Organization
Organization Name:SPIRA INNOVATIONS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRINDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-395-3520
Mailing Address - Street 1:SPIRA CARE OVERLAND PARK 7341 W. 133RD ST.
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4750
Mailing Address - Country:US
Mailing Address - Phone:191-329-7747
Mailing Address - Fax:
Practice Address - Street 1:SPIRA CARE OVERLAND PARK 7341 W. 133RD ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213
Practice Address - Country:US
Practice Address - Phone:191-329-7747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPIRA CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty