Active NPI
Jared Bashaw
- Athletic Trainer
- Kansas City, KS
National Provider Identifier
1003586132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 24-01213
- Practice address
- 1800 Village West Pkwy
Kansas City, KS 66111-1825 - Phone
- (913) 328-5618
- NPI assigned
- Sep 20, 2021
- Last updated
- Sep 20, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 24-01213 | KS | Primary |
Addresses
Primary practice location
1800 Village West Pkwy
Kansas City, KS 66111-1825
Mailing address
13320 Hauser St Apt 3303
Overland Park, KS 66213-2477
Phone (620) 218-2855
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24-01213 | KS | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632096000000",
"number": "1003586132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13320 HAUSER ST APT 3303",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662132477",
"telephone_number": "620-218-2855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 VILLAGE WEST PKWY",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "661111825",
"telephone_number": "913-328-5618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASHAW",
"first_name": "JARED",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-09-20",
"last_updated": "2021-09-20",
"certification_date": "2021-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "KS",
"license": "24-01213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.