Individual provider Active NPI

H. Marcus Needham, MPT

  • Physical Therapist
  • Wichita, KS
National Provider Identifier
1356316830
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-02111 Issued in KS
Practice address
9300 E 29TH St N
Ste 205
Wichita, KS 67226-2182
Phone
(316) 219-8299
Fax
(316) 219-5899
NPI assigned
Feb 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11-02111 KS Primary
Physical Therapist 225100000X KS

Addresses

Primary practice location

9300 E 29TH St N
Ste 205
Wichita, KS 67226-2182

Mailing address

9300 E 29TH St N
Suite 205
Wichita, KS 67226-2182
Phone (316) 219-8299

Other identifiers 1

IdentifierTypeStateIssuer
11-02111OtherKSSTATE LISCENCE NUMBER

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-02111KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fasttrack Physical Therapy and Sports Rehabilitation PastSince Jan 6, 2005 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1356316830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 E 29TH ST N",
            "address_2": "SUITE 205",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262182",
            "telephone_number": "316-219-8299",
            "fax_number": "316-219-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 E 29TH ST N",
            "address_2": "STE 205",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262182",
            "telephone_number": "316-219-8299",
            "fax_number": "316-219-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEEDHAM",
        "first_name": "H.",
        "middle_name": "MARCUS",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-20",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-02111",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISCENCE NUMBER",
            "identifier": "11-02111",
            "state": "KS"
        }
    ],
    "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 Mar 12, 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.