James Bradley Rea, PA-C
Individual provider Active NPI Physician Assistant · Topeka, KS
NPI 1316933237 · NPPES record last updated Jun 6, 2008
Key facts
- NPI
- 1316933237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1500380 (KS)
- Practice address
- 6001 SW 6TH Ave
Suite 200
Topeka, KS 66615-1011 - Phone
- (785) 233-7491
- Fax
- (785) 233-3187
- NPI assigned
- Sep 26, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1500380 | KS | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1500380 | KS | Yes |
Addresses
Primary practice location
6001 SW 6TH Ave
Suite 200
Topeka, KS 66615-1011
Mailing address
6001 SW 6TH Ave
Suite 200
Topeka, KS 66615-1011
Phone (785) 233-7491
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100340710A | Medicaid | KS |
Other providers in Topeka, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.