Gulledge Family Wellness PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

01-05085 Issued in KS

Legal business name

GULLEDGE FAMILY WELLNESS PA

Practice address

11879 W 112TH St
Suite 100
Overland Park, KS 66210-2725

Phone

(913) 338-1112

Fax

(913) 338-2079

NPI assigned

Dec 9, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Shirin Moshiri Gulledge, D.C.

Title

Chiropractor

Phone

(913) 338-1112

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379462400000",
    "number": "1205165958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11879 W 112TH ST",
            "address_2": "SUITE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102725",
            "telephone_number": "913-338-1112",
            "fax_number": "913-338-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11879 W 112TH ST",
            "address_2": "SUITE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102725",
            "telephone_number": "913-338-1112",
            "fax_number": "913-338-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULLEDGE FAMILY WELLNESS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-09",
        "last_updated": "2013-09-18",
        "status": "A",
        "authorized_official_last_name": "GULLEDGE",
        "authorized_official_first_name": "SHIRIN",
        "authorized_official_middle_name": "MOSHIRI",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "913-338-1112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE I NPI",
            "identifier": "1275676371",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guillermo Guillen, DDS
• Jorge Guillen, MD
• Hannah Guillies
• Cody Guinn
• Gulledge Family Wellness P.a.
• Gulledge Family Wellness, LLC
• David Lauchlin Gulledge, D.C.
• Kyle Vincent Gulledge, D.C.
• Shirin Moshiri Gulledge, D.C.
• Natalie R Gulley, PT

• Chiropractor in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.