NPIMap

Organization Active NPI

Willow Tree LLC

  • Marriage & Family Therapist
  • Wichita, KS
National Provider Identifier
1306233077
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
WILLOW TREE LLC
Practice address
7348 W 21St St N
Suite 107
Wichita, KS 67205-1793
Phone
(316) 779-2560
Fax
(316) 854-2303
NPI assigned
Apr 21, 2015
Last updated
Apr 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Authorized official

Name
Mr. Shelby Batt, LMSWNPI 1306285937
Title
Partner
Phone
(316) 779-2560

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X KS Primary

Addresses

Primary practice location

7348 W 21St St N
Suite 107
Wichita, KS 67205-1793

Mailing address

7348 W 21St St N
Suite 107
Wichita, KS 67205-1793
Phone (316) 779-2560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150811004067 KS Part B Supplier - Clinic/Group Practice 1658686324 Receives reassigned benefits from 12 practitioners
Practice locations: Wichita, KS

National Provider Directory

National Provider Directory

Locations

7348 W 21st St N
Ste 107
Wichita, KS 67205
Phone (316) 779-2560

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1306233077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7348 W 21ST ST N",
            "address_2": "SUITE 107",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051793",
            "telephone_number": "316-779-2560",
            "fax_number": "316-854-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7348 W 21ST ST N",
            "address_2": "SUITE 107",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672051793",
            "telephone_number": "316-779-2560",
            "fax_number": "316-854-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "BATT",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "316-779-2560",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.