Trauma Recovery Services, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP-377 Issued in KS

Legal business name

TRAUMA RECOVERY SERVICES, INC.

Practice address

10925 Antioch Rd Ste 103
Overland Park, KS 66210-2119

Phone

(913) 469-6069

Fax

(913) 469-0604

NPI assigned

Feb 13, 2012

Organization subpart

No

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

Authorized official

Name

Dr. John L. Nieters, PH.D.NPI 1053334623

Title

Owner

Phone

(913) 469-6069

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John L Nieters, PHD

  • Clinical Psychologist
  • Lawrence, KS
  • NPI 1053334623
  Medicare reassignment NPD Authorized official
• Ann Pilar Jacobson, PH.D.

  • Psychologist
  • Overland Park, KS
  • NPI 1558414458
  NPD (past)

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1316210982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10925 ANTIOCH RD STE 103",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102119",
            "telephone_number": "913-469-6069",
            "fax_number": "913-469-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10925 ANTIOCH RD STE 103",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102119",
            "telephone_number": "913-469-6069",
            "fax_number": "913-469-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMA RECOVERY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-13",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "NIETERS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "913-469-6069",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "LP-377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100240310A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tranquility Case Management
• Transforming Care, LLC
• Transitions - Counseling for Change
• Brian E. Trast, CRNA
• Danielle Traudt, APRN
• TRB Enterprises
• Deann Treece-Bauman
• Karen K Trees, NP
• Jerri L. Tregellas, LSCSW, LCSW
• Michael Trenkamp

• Clinical Psychologist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Clinical Psychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.