Individual provider Active NPI

Sharon B Roseberry, P.T.

  • Physical Therapist
  • Wichita, KS
National Provider Identifier
1174619936
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-02169 Issued in KS
Practice address
13303 W Maple St
Wichita, KS 67235-8757
Phone
(316) 854-5859
Fax
(316) 854-5860
NPI assigned
Oct 5, 2006
Last updated
Mar 27, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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 11-02169 KS Primary

Addresses

Primary practice location

13303 W Maple St
Wichita, KS 67235-8757

Mailing address

200 W Douglas Ave
Ste 1040
Wichita, KS 67202-3017
Phone (316) 263-0003

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

LicenseStateTypeSpecialty
11-02169KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Tranquillity Physical Therapy Inc Physical Therapist PastSince Dec 5, 2022 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1174619936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W DOUGLAS AVE",
            "address_2": "STE 1040",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672023017",
            "telephone_number": "316-263-0003",
            "fax_number": "316-263-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13303 W MAPLE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672358757",
            "telephone_number": "316-854-5859",
            "fax_number": "316-854-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBERRY",
        "first_name": "SHARON",
        "middle_name": "B",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-02169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.

Verify at the official NPI Registry.