Active NPI
Shane Louis Oliverius, D.C.
- Chiropractor
- Overland Park, KS
National Provider Identifier
1104043124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- T-01164
- Practice address
- 9150 Glenwood St
Overland Park, KS 66212-1364 - Phone
- (913) 385-1999
- NPI assigned
- Apr 19, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | T-01164 | KS | Primary |
Addresses
Primary practice location
9150 Glenwood St
Overland Park, KS 66212-1364
Mailing address
12404 Cherry St
Kansas City, MO 64145-1155
Phone (913) 669-0970
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 |
|---|---|---|---|
| T-01164 | KS | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104043124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12404 CHERRY ST",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641451155",
"telephone_number": "913-669-0970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9150 GLENWOOD ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662121364",
"telephone_number": "913-385-1999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVERIUS",
"first_name": "SHANE",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KS",
"license": "T-01164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.