Shane Dean Bisson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

01-04781 Issued in KS

Practice address

12256 State Line Rd
Leawood, KS 66209-1256

Phone

(913) 345-9888

Fax

(913) 345-0958

NPI assigned

May 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1265489520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12256 STATE LINE RD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662091256",
            "telephone_number": "913-345-9888",
            "fax_number": "913-345-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12256 STATE LINE RD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662091256",
            "telephone_number": "913-345-9888",
            "fax_number": "913-345-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSON",
        "first_name": "SHANE",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-04781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "31615016",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "125178",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7303408",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makenzie Paige Bickers, PMHNP-BC
• Abbey Bingham
• Bio Solutions, LLC
• Kelsey Biro
• Maha Bishr, MA CCC-SLP
• Karen Janelle Black, RN
• Anne M Blake, MD
• Rebecca Nicole Boan, M.S., R.D., L.D.
• Ariel Bock
• Taylor R Bock, M.S., CCC-SLP

• Chiropractor in Leawood, KS
• Providers in Leawood, KS by specialty
• Chiropractor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.