SOUTH KANSAS CITY SURGICENTER
NPI 1114924685
Clinic/Center - Ambulatory Surgical in Overland Park, KS

NPI Status: Active since June 30, 2005

Contact Information

10730 NALL AVE
SUITE 100
OVERLAND PARK, KS
ZIP 66211
Phone: (913) 901-9000
Fax: (913) 901-9030

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 17D0998154
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 04-07-2028

About SOUTH KANSAS CITY SURGICENTER

This page provides the complete NPI Profile along with additional information for South Kansas City Surgicenter, a provider established in Overland Park, Kansas operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1114924685 assigned on June 2005. The practitioner's primary taxonomy code is 261QA1903X with license number S046019 (KS). The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as South Kansas City Surgicenter. The authorized official of this NPI record is Mrs. Christine Blackburn Bsn, Rn, Cnor (Administrator)

NPI
1114924685
Provider Legal Name
SOUTH KANSAS CITY SURGICAL CENTER, LC
Other Organization Name
SOUTH KANSAS CITY SURGICENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
10730 NALL AVE SUITE 100 OVERLAND PARK, KS 66211
Location Phone
(913) 901-9000
Location Fax
(913) 901-9030
Mailing Address
10730 NALL AVE SUITE 100 OVERLAND PARK, KS 66211
Mailing Phone
(913) 901-9000
Mailing Fax
(913) 901-9030
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-30-2005
Last Update Date
07-30-2021
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
S046019
License State
KS

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Anthem Bronze Pathway 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Catastrophic Pathway (+ Incentives) - EPO
  • Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Silver Pathway 3100 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 7200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Essential (No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Bronze Standard+ (Dental + Vision, No Referrals) - EPO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Advantage ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. CHRISTINE BLACKBURN BSN, RN, CNOR

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(913) 901-9000

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
200310690AMEDICAID (05)KS 

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Evaluation of sleep-disordered breathing by examination of upper airway using an endoscope

This procedure examines your upper airway for sleep-related breathing issues. An endoscope, a thin tube with a light and camera, is gently inserted through your nose. This allows a detailed view of your airway to identify any abnormalities that could disrupt your sleep.

This service was performed 12 times for 12 patients

Exam of nose and sinus with removal of nasal sinus using an endoscope

This procedure involves using an endoscope, a thin tube with a light and camera, to examine your nose and sinuses. If necessary, unwanted tissue from the nasal sinus is removed. This can help improve breathing and alleviate sinus issues.

This service was performed 26 times for 13 patients

Exploration of nasal sinus using an endoscope

Exploration of the nasal sinus using an endoscope is a procedure where a thin, flexible tube with a light and camera attached is inserted into the nose. This allows the doctor to view and examine the sinuses in detail, aiding in the diagnosis and treatment of sinus issues.

This service was performed 48 times for 24 patients

Extensive repair of turning-outward eyelid defect

This procedure corrects an eyelid defect where the eyelid turns outward, exposing the eye. The extensive repair involves surgical techniques to reshape the eyelid and ensure it functions properly. This helps protect the eye and improve comfort.

This service was performed 34 times for 17 patients

Removal of excessive skin and fat of upper eyelid

This procedure, also known as upper eyelid surgery, is performed to remove excess skin and fat from the upper eyelid. It can help improve vision if heavy eyelids hinder it, and can also enhance the appearance of the eyes. It's a common, safe procedure.

This service was performed 26 times for 13 patients

Removal of nasal air passage under lining tissue

This procedure, often done to improve breathing or address sinus issues, involves the removal of tissue from the lining of the nasal air passage. It's performed under anesthesia and recovery time varies based on individual health status.

This service was performed 78 times for 39 patients

Removal of nasal sinus tissue using an endoscope

This procedure, known as endoscopic sinus surgery, involves using a thin, flexible tube with a light and camera to view and remove problematic nasal sinus tissue. It helps to alleviate sinus issues and improve breathing.

This service was performed 55 times for 28 patients

Removal of tissue from sphenoid sinus using an endoscope

This is a procedure where a small camera (endoscope) is used to view and remove tissue from the sphenoid sinus, a space in the back of your nose. It helps to diagnose or treat conditions affecting this area. Minimal discomfort is expected.

This service was performed 24 times for 12 patients

Repair of tendon of upper eyelid

Repair of the tendon of the upper eyelid is a surgical procedure aimed at fixing a droopy eyelid. This condition can affect your vision and appearance. The procedure involves tightening the tendon to lift the eyelid to its normal position, improving both function and aesthetics.

This service was performed 26 times for 14 patients

Reshaping of nasal cartilage

Reshaping of nasal cartilage, also known as rhinoplasty, is a surgical procedure to modify the structure of the nose for aesthetic or functional purposes. It involves adjusting the cartilage and bone in the nose to achieve the desired shape or to improve breathing.

This service was performed 30 times for 30 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
17D0998154
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
April 08, 2026
Certificate Expiration Date
April 07, 2028
Laboratory Director
KATHERINE CUNDIFF
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to South Kansas City Surgicenter to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1114924685, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
1
Doubled → 2
Pos 4
4
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
2
Unchanged
Pos 7
4
Doubled → 8
Pos 8
6
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 9 → 18 → 9 4 → 8 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 2 + 4 + 1 + 8 + 2 + 8 + 6 + 1 + 6 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1114924685.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Surgery (Vascular Surgery)
10730 NALL AVE, SUITE 101
OVERLAND PARK, KS 66211
Surgery
10730 NALL AVE
OVERLAND PARK, KS 66211
Nurse Anesthetist, Certified Registered
10730 NALL AVE, 100
OVERLAND PARK, KS 66211
Orthopaedic Surgery
10730 NALL AVE, SUITE 200
OVERLAND PARK, KS 66211
Physical Therapist
10730 NALL AVE, SUITE 203
OVERLAND PARK, KS 66211
Physical Therapist
10730 NALL AVE, STE 200
OVERLAND PARK, KS 66211
Family Medicine
10730 NALL AVE, SUITE 100
OVERLAND PARK, KS 66211
Surgery (Vascular Surgery)
10730 NALL AVE, SUITE 101
OVERLAND PARK, KS 66211
Nurse Practitioner
10730 NALL AVE, SUITE 101
OVERLAND PARK, KS 66211
Specialist/Technologist (Athletic Trainer)
10730 NALL AVE, SUITE 200
OVERLAND PARK, KS 66211
Pathology (Anatomic Pathology & Clinical Pathology)
10730 NALL AVE, STE 100
OVERLAND PARK, KS 66211
Family Medicine (Adult Medicine)
10730 NALL AVE, STE. 200
OVERLAND PARK, KS 66211
Specialist/Technologist (Athletic Trainer)
10730 NALL AVE, SUITE 200
OVERLAND PARK, KS 66211
Point of Service
10730 NALL AVE, SUITE 200
OVERLAND PARK, KS 66211
Point of Service
10730 NALL AVE, 200
OVERLAND PARK, KS 66211
Nurse Practitioner
10730 NALL AVE, STE 101
OVERLAND PARK, KS 66211
Surgery
10730 NALL AVE, SUITE 200
OVERLAND PARK, KS 66211
Specialist
10730 NALL AVE, SUITE 204
OVERLAND PARK, KS 66211
Physical Therapist
10730 NALL AVE
OVERLAND PARK, KS 66211
Specialist/Technologist (Athletic Trainer)
10730 NALL AVE
OVERLAND PARK, KS 66211

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114924685, enumerated as an "organization" on June 30, 2005.

The provider is located at 10730 NALL AVE SUITE 100 OVERLAND PARK, KS 66211 and the phone number is (913) 901-9000.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from. Please consult your insurance carrier or call the provider to verify.