Provider Demographics
NPI:1407167661
Name:KANSAS CITY PSYCHIATRIC CONSULTANTS, INC
Entity type:Organization
Organization Name:KANSAS CITY PSYCHIATRIC CONSULTANTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHBAZ
Authorized Official - Middle Name:M
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-291-4700
Mailing Address - Street 1:4240 BLUE RIDGE BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64133-1705
Mailing Address - Country:US
Mailing Address - Phone:816-291-4700
Mailing Address - Fax:816-291-4600
Practice Address - Street 1:4240 BLUE RIDGE BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64133
Practice Address - Country:US
Practice Address - Phone:816-291-4700
Practice Address - Fax:816-291-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000145787273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1437213998OtherNPI INDIVIDUAL
MO1548615073OtherNPI INDIVIDUAL
MO1962591313OtherNPI INDIVIDUAL
MO1952361545OtherNPI INDIVIDUAL