Active NPI
John Listerman, MD
- Family Medicine Physician
- Lawrence, KS
National Provider Identifier
1073549820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 420040
- Practice address
- 1 Riverfront PLZ
Suite 100
Lawrence, KS 66044-2293 - Phone
- (785) 841-7297
- Fax
- (785) 856-0375
- NPI assigned
- Jun 23, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 420040 | KS | Primary |
Addresses
Primary practice location
1 Riverfront PLZ
Suite 100
Lawrence, KS 66044-2293
Mailing address
1 Riverfront PLZ
Suite 100
Lawrence, KS 66044-2293
Phone (785) 841-7297
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100117670B | Medicaid | KS |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 420040 | KS | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heartland Medical Clinic, Inc. | Family Medicine | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Lawrence, KS
- NPI 1487107447
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294099200000",
"number": "1073549820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 RIVERFRONT PLZ",
"address_2": "SUITE 100",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660442293",
"telephone_number": "785-841-7297",
"fax_number": "785-856-0375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 RIVERFRONT PLZ",
"address_2": "SUITE 100",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660442293",
"telephone_number": "785-841-7297",
"fax_number": "785-856-0375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISTERMAN",
"first_name": "JOHN",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-23",
"last_updated": "2011-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KS",
"license": "420040",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100117670B",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.