Individual provider Active NPI

Kristian Elizabeth Shanline, MSW

  • Social Worker
  • Kansas City, KS
National Provider Identifier
1265590673
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
4886 Issued in KS
Practice address
1301 N 47TH St
Kansas City, KS 66102-1705
Phone
(913) 328-4698
Fax
(913) 328-4603
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 4886 KS Primary

Addresses

Primary practice location

1301 N 47TH St
Kansas City, KS 66102-1705

Mailing address

7908 Campbell St
Kansas City, MO 64131-2155
Phone (913) 328-4698

Other identifiers 1

IdentifierTypeStateIssuer
10098080AMedicaidKS

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

LicenseStateTypeSpecialty
4886KSMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1265590673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7908 CAMPBELL ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641312155",
            "telephone_number": "913-328-4698",
            "fax_number": "913-328-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N 47TH ST",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661021705",
            "telephone_number": "913-328-4698",
            "fax_number": "913-328-4603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANLINE",
        "first_name": "KRISTIAN",
        "middle_name": "ELIZABETH",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "4886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10098080A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.