Active NPI
Ann B Haberly, PTA
- Physical Therapy Assistant
- Wichita, KS
National Provider Identifier
1194032110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 14-01526
- Practice address
- 10100 Shannon Woods
Wichita, KS 67226 - Phone
- (316) 858-1900
- Fax
- (316) 858-1914
- NPI assigned
- Sep 13, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 14-01526 | KS | Primary |
Addresses
Primary practice location
10100 Shannon Woods
Wichita, KS 67226
Mailing address
10100 Shannon Woods
Wichita, KS 67226
Phone (316) 858-1900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 311810056 | Other | KS | TAX ID |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14-01526 | KS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284336000000",
"number": "1194032110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10100 SHANNON WOODS",
"city": "WICHITA",
"state": "KS",
"postal_code": "67226",
"telephone_number": "316-858-1900",
"fax_number": "316-858-1914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10100 SHANNON WOODS",
"city": "WICHITA",
"state": "KS",
"postal_code": "67226",
"telephone_number": "316-858-1900",
"fax_number": "316-858-1914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HABERLY",
"first_name": "ANN",
"middle_name": "B",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-13",
"last_updated": "2010-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "14-01526",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "311810056",
"state": "KS"
}
],
"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 Sep 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.