John E Shero, CPED
Individual provider Active NPI Specialist · Wichita, KS
NPI 1013145804 · NPPES record last updated Jul 12, 2018
Key facts
- NPI
- 1013145804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 66 (OK)
- Practice address
- 135 N Main St
Wichita, KS 67202 - Phone
- (866) 997-3425
- NPI assigned
- Jun 30, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66 | OK | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bearfoot Shoes, LLC | Current | Accepting new patients | |
| Regal Medical Supply, LLC | Past | Accepting new patients |
Locations
1205 Medical Plaza Ct
Granbury, TX 76048
Phone (817) 573-4123
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 66 | OK | Yes |
Addresses
Primary practice location
135 N Main St
Wichita, KS 67202
Mailing address
1205 Medical Plaza CT
Granbury, TX 76048-5684
Phone (178) 900-2250
Other practice location 1
135 N Main St
Wichita, KS 67202-1400
Phone (866) 997-3425
Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.