Active NPI
Ronald Wayne Hines, DPM
- Podiatrist
- Leawood, KS
National Provider Identifier
1023011616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 12-00387
- Practice address
- 4513 W 124TH LN
Leawood, KS 66209-2603 - Phone
- (405) 659-1842
- Fax
- (913) 261-9255
- NPI assigned
- May 27, 2005
- Last updated
- Apr 11, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 2012014963 | MO | |
| Podiatrist | 213E00000X | 12-00387 | KS | Primary |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 113 | OK |
Addresses
Primary practice location
4513 W 124TH LN
Leawood, KS 66209-2603
Mailing address
4513 W 124TH LN
Leawood, KS 66209-2603
Phone (405) 659-1842
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0764240001 | Other | OK | DMERC |
| 731130289001 | Other | OK | BLUE CROSS BLUE SHIELD |
| 1295773398 | Other | OK | GROUP NPI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12-00387 | KS | MD | Podiatrist |
| 113 | OK | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365638400000",
"number": "1023011616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4513 W 124TH LN",
"city": "LEAWOOD",
"state": "KS",
"postal_code": "662092603",
"telephone_number": "405-659-1842",
"fax_number": "913-261-9255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4513 W 124TH LN",
"city": "LEAWOOD",
"state": "KS",
"postal_code": "662092603",
"telephone_number": "405-659-1842",
"fax_number": "913-261-9255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINES",
"first_name": "RONALD",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-27",
"last_updated": "2013-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MO",
"license": "2012014963",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "KS",
"license": "12-00387",
"primary": true
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "OK",
"license": "113",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMERC",
"identifier": "0764240001",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "731130289001",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1295773398",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Leawood, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.