Provider Demographics
NPI:1528121316
Name:SAINT LUKES SOUTH SURGERY CENTER LLC
Entity type:Organization
Organization Name:SAINT LUKES SOUTH SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-378-1400
Mailing Address - Street 1:12541 FOSTER ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-2630
Mailing Address - Country:US
Mailing Address - Phone:913-378-1400
Mailing Address - Fax:
Practice Address - Street 1:12541 FOSTER
Practice Address - Street 2:SUITE 120
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213
Practice Address - Country:US
Practice Address - Phone:913-378-1400
Practice Address - Fax:913-378-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
7540975OtherAETNA
134961402753OtherHUMANA
302782OtherCOVENTRY
91307013OtherBLUE CROSS BLUE SHIELD
7540975OtherAETNA