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EXCELSIOR SPRINGS PHYSICIANS CLINIC
NPI 1629491105
Family Medicine - Adolescent Medicine in Excelsior Springs, MO

Active since February 04, 2014
1700 RAINBOW BLVD, EXCELSIOR SPRINGS, MO 64024(816) 629-2623(816) 629-2722 Get Directions Write a Review

NPPES record last updated: February 4, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Excelsior Springs Physicians Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EXCELSIOR SPRINGS PHYSICIANS CLINIC (NPI 1629491105) is a healthcare organization registered as an adolescent medicine in Excelsior Springs, Missouri and active in the NPI registry since February 2014. The organization lists Jennifer L Boomgarden, Physicians Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1629491105
Entity TypeOrganization
Primary Taxonomy207QA0000X
Legal Business NameEXCELSIOR SPRINGS PHYSICIANS CLINIC
Location Address1700 RAINBOW BLVDExcelsior Springs, MO 64024-1182
Mailing Address1010 N Jesse James RdExcelsior Springs, MO 64024-1202 · (816) 630-6722 · Fax (816) 630-2471
Phone(816) 629-2623
Fax(816) 629-2722
Organization SubpartNo
Authorized OfficialJennifer L BoomgardenPhysicians Practice Manager · (816) 629-2623
Enumeration DateFebruary 4, 2014
✔ NPI 1629491105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0000X
License✔ Licensed in MO · R6J43
Definition
A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
1700 RAINBOW BLVD, Excelsior Springs, MO 64024
Open in Google Maps ↗

Other Identifiers 1

OtherMA 4388MO · Medicare Id#

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EXCELSIOR SPRINGS CITY HOSPITAL
Nursing Facility/Intermediate Care Facility
1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO 64024
Clay County (816) 630-6081
MERITAS HEALTH CORPORATION
Otolaryngology
1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO 64024
Clay County (816) 468-8820
PETISHA DAVIS FNP
Nurse Practitioner (Family)
1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO 64024
Clay County (816) 630-6081
JENNIFER LYNN FRY LMSW
Counselor (Mental Health)
1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO 64024
Clay County (816) 629-8821
AMANDA JANE FINDLEY PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO 64024
Clay County (816) 630-6081
EXCELSIOR SPRINGS HOSPITAL
General Acute Care Hospital (Rural)
1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO 64024
Clay County (816) 630-6081
DR. KYLE LEE ROOF PHARMD
Pharmacist
1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO 64024
Clay County (816) 629-3667
DAVID H MILLER PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
1700 RAINBOW BLVD
EXCELSIOR SPRINGS, MO 64024
Clay County (816) 629-6596

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Excelsior Springs Physicians Clinic's NPI number?

The NPI number for Excelsior Springs Physicians Clinic is 1629491105. It was assigned to this organization in the NPPES registry on February 4, 2014.

Where is Excelsior Springs Physicians Clinic located?

Excelsior Springs Physicians Clinic is located at 1700 Rainbow Blvd, Excelsior Springs, MO 64024. The listed phone number is (816) 629-2623.

What is Excelsior Springs Physicians Clinic's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adolescent Medicine, with taxonomy code 207QA0000X.

When was this NPI record last updated?

The NPPES record for Excelsior Springs Physicians Clinic was last updated on February 4, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.