Individual provider Active NPI

Aaron Max Eugene Stapleton, DPT

  • Physical Therapist
  • Dodge City, KS
National Provider Identifier
1114511318
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-06220 Issued in KS
Practice address
1909 N 14TH Ave Ste C
Dodge City, KS 67801-2365
Phone
(620) 338-8633
Fax
(620) 338-8121
NPI assigned
Feb 27, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-06220 KS Primary

Addresses

Primary practice location

1909 N 14TH Ave Ste C
Dodge City, KS 67801-2365

Mailing address

1909 N 14TH Ave Ste C
Dodge City, KS 67801-2365
Phone (620) 338-8633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210419002170 KS Practitioner - Physical Therapist in Private Practice 5294143913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Physical Therapy and Sports Performance LLCGroup PAC ID 6406229095, 4 clinicians

Practice addresses (Care Compare)

1909 N 14TH Ave
Suite C PT Works
Dodge City, KS 67801-2365
Phone (620) 338-8633

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-06220KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Physical Therapy and Sports Performance, LLC Physical Therapist CurrentSince Jan 1, 2023 Accepting new patients

Locations

1909 N 14th Ave
Ste C
Dodge City, KS 67801
Phone (620) 338-8633

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.

NPI Registry JSON

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

{
    "created_epoch": "1614384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1114511318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 N 14TH AVE STE C",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012365",
            "telephone_number": "620-338-8633",
            "fax_number": "620-338-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 N 14TH AVE STE C",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012365",
            "telephone_number": "620-338-8633",
            "fax_number": "620-338-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLETON",
        "first_name": "AARON",
        "middle_name": "MAX EUGENE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-27",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-06220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.