Active NPI
Shonda L Kooser, T-MFT 03519-T
- Marriage & Family Therapist
- Derby, KS
National Provider Identifier
1265219265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 03519-T
- Practice address
- 1221 N Rock Rd
Derby, KS 67037-3678 - Phone
- (316) 789-8511
- NPI assigned
- Sep 12, 2023
- Last updated
- Sep 12, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 03519-T | KS | Primary |
Addresses
Primary practice location
1221 N Rock Rd
Derby, KS 67037-3678
Mailing address
1431 E Woodbrook CT
Derby, KS 67037-9713
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 |
|---|---|---|---|
| 03519-T | KS | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prairie View, Inc. | Past | Accepting new patients | |
| Prairie View Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Newton, KS
- NPI 1578252904
-
- Psychiatry Physician
- Newton, KS
- NPI 1558426486
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1265219265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1431 E WOODBROOK CT",
"city": "DERBY",
"state": "KS",
"postal_code": "670379713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1221 N ROCK RD",
"city": "DERBY",
"state": "KS",
"postal_code": "670373678",
"telephone_number": "316-789-8511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOOSER",
"first_name": "SHONDA",
"middle_name": "L",
"credential": "T-MFT 03519-T",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-12",
"last_updated": "2023-09-12",
"certification_date": "2023-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "KS",
"license": "03519-T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Derby, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.