COLLEGE PARK ANCILLARY, LLC
NPI 1508203241
Clinic/Center - Ambulatory Surgical in Overland Park, KS

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

Active since June 03, 2013

10600 MASTIN ST, OVERLAND PARK, KS 66212(913) 438-0868 Get Directions Write a Review

NPPES record last updated: June 4, 2013. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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NPI Profile Information
Primary Taxonomy
Authorized Official
Other Providers Same Location
Frequently Asked Questions

Organization
Clinic/Center
Ambulatory Surgical

About COLLEGE PARK ANCILLARY, LLC

This page provides the complete NPI Profile along with additional information for College Park Ancillary, Llc, 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 1508203241 assigned on June 2013. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Todd Carlon (Vice President)

NPI: 1508203241 Verify this NPI
Provider Name: COLLEGE PARK ANCILLARY, LLC
Entity Type: Organization
Location Address: 10600 MASTIN ST OVERLAND PARK, KS 66212
Location Phone: (913) 438-0868
Mailing Address: 11755 W 112TH ST SUITE 202 OVERLAND PARK, KS 66210
Mailing Phone: (913) 469-0433
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 06-03-2013
Last Update Date: 06-04-2013
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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

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: TODD CARLON
Authorized Official Title: VICE PRESIDENT
Authorized Official Phone: (816) 508-4090