Northwest Kansas Tech College

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

XSB886824257 Issued in KS

Legal business name

NORTHWEST KANSAS TECH COLLEGE

Practice address

1209 Harrison Ave
Goodland, KS 67735-3441

Phone

(785) 890-1539

NPI assigned

Nov 9, 2016

Last updated

Nov 9, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shelby Ann Heatwole, ATC, LATNPI 1437691375

Title

Head Athletic Trainer

Phone

(620) 290-4687

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shelby Ann Heatwole, ATC, LAT

  • Orthopedic Assistant
  • Goodland, KS
  • NPI 1437691375
  NPD (past) Authorized official

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1275075103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 BROADWAY",
            "city": "GOODLAND",
            "state": "KS",
            "postal_code": "67735",
            "telephone_number": "785-890-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 HARRISON AVE",
            "city": "GOODLAND",
            "state": "KS",
            "postal_code": "677353441",
            "telephone_number": "785-890-1539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST KANSAS TECH COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-09",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "HEATWOLE",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "HEAD ATHLETIC TRAINER",
        "authorized_official_telephone_number": "620-290-4687",
        "authorized_official_credential": "ATC, LAT"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "KS",
            "license": "XSB886824257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morrison Optometric Associates, PA (Vision Source of Goodland)
• New Patterns, LLC
• Newman Vision Care LLC
• Ryan Joseph Newman, O.D.
• Leon R Nielsen, CRNA
• Lauren Pankonin, PTA
• Lisa Paxton
• Megan Gay Pearce, D.D.S.
• Gabrielle Perryman
• Pioneer Health LLC

• Preferred Provider Organization in Goodland, KS
• Providers in Goodland, KS by specialty
• Preferred Provider Organization in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.