Pura Vida Therapy, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PURA VIDA THERAPY, LLC

Practice address

12480 W 62ND Ter Ste 100
Shawnee, KS 66216-1871

Phone

(913) 788-8888

NPI assigned

Mar 16, 2007

Last updated

Nov 8, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Allen Child, PTNPI 1134123680

Title

Owner

Phone

(913) 788-8888

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Allen Anthony Child, PT

  • Orthopedic Physical Therapist
  • Shawnee, KS
  • NPI 1134123680
  Medicare reassignment Authorized official
• Millie Hatfield, DPT

  • Physical Therapist
  • Overland Park, KS
  • NPI 1184322059
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1053435024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12480 W 62ND TER STE 100",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662161871",
            "telephone_number": "913-788-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12480 W 62ND TER STE 100",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662161871",
            "telephone_number": "913-788-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURA VIDA THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "CHILD",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-788-8888",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "3484",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Providence Urgent Care Center
• Brenna Pruitt
• Abby Leigh Puckett, PT, DPT
• Melanie Elizabeth Pugh, LMSW
• Sarah Pugh
• Pure Motion Chiropractic & Rehab, LLC
• Quality Care Living
• Alexandria Quinn
• Amanda Renee Rader, CCC-SLP
• James Henry Ralstin, M.D.

• Specialist in Shawnee, KS
• Providers in Shawnee, KS by specialty
• Specialist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.