Individual provider Active NPI

Kentaro Ishii

  • Athletic Trainer
  • Kansas City, MO
National Provider Identifier
1275953192
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2008020483 Issued in MO
Practice address
6310 Lewis Rd
Kansas City, MO 64132-3200
Phone
(913) 387-3825
NPI assigned
Apr 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2008020483 MO Primary

Addresses

Primary practice location

6310 Lewis Rd
Kansas City, MO 64132-3200

Mailing address

6310 Lewis Rd
Kansas City, MO 64132-3200
Phone (913) 387-3825

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
2008020483MOMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397692800000",
    "number": "1275953192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6310 LEWIS RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641323200",
            "telephone_number": "913-387-3825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6310 LEWIS RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641323200",
            "telephone_number": "913-387-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISHII",
        "first_name": "KENTARO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-17",
        "last_updated": "2014-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2008020483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.