Individual provider Active NPI

John Anthony Vivona, PTA

  • Respiratory/Developmental/Rehabilitative Specialist/Technologist
  • Overland Park, KS
National Provider Identifier
1316125818
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respiratory/Developmental/Rehabilitative Specialist/TechnologistTaxonomy code 225500000X
License
2001006780 Issued in MO
Practice address
10300 W 103Rd St
Suite 300
Overland Park, KS 66214-2642
Phone
(913) 894-1910
NPI assigned
Feb 6, 2008
Last updated
Feb 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Respiratory/Developmental/Rehabilitative Specialist/Technologist 225500000X 2001006780 MO Primary

Addresses

Primary practice location

10300 W 103Rd St
Suite 300
Overland Park, KS 66214-2642

Mailing address

8239 NW Barrybrooke CT
Kansas City, MO 64151-1057

Other identifiers 1

IdentifierTypeStateIssuer
2001006780OtherMOSTATE LICENSE

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
2001006780MOMDRespiratory/Developmental/Rehabilitative Specialist/Technologist

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1316125818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8239 NW BARRYBROOKE CT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641511057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 W 103RD ST",
            "address_2": "SUITE 300",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662142642",
            "telephone_number": "913-894-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVONA",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "MO",
            "license": "2001006780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2001006780",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; 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.