NPIMap

Organization Active NPI

College Park Ancillary, LLC

Doing business as College Park Physical Therapy

  • Physical Therapy Clinic/Center
  • Overland Park, KS
National Provider Identifier
1356617757
Registry record updated Oct 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
COLLEGE PARK ANCILLARY, LLC
Doing business as
College Park Physical Therapy
Practice address
10600 Mastin St
Overland Park, KS 66212-5723
Phone
(913) 681-0606
Fax
(913) 338-1311
NPI assigned
Mar 29, 2012
Last updated
Oct 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2013

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

Authorized official

Name
Charles O Chambers
Title
Administrator
Phone
(913) 469-0503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

10600 Mastin St
Overland Park, KS 66212-5723

Mailing address

PO Box 742554
Atlanta, GA 30374-2105
Phone (913) 469-0503

Other names 1

  • College Park Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
College Park Ancillary LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11164 S Noble Dr
Ste 102
Olathe, KS 66061
Phone (913) 553-2100

15100 Metcalf Ave
Ste 102
Stanley, KS 66223
Phone (913) 681-0606

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381449600000",
    "number": "1356617757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742554",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742105",
            "telephone_number": "913-469-0503",
            "fax_number": "913-469-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 MASTIN ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662125723",
            "telephone_number": "913-681-0606",
            "fax_number": "913-338-1311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLEGE PARK ANCILLARY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-29",
        "last_updated": "2013-10-11",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "913-469-0503"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "College Park Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 11, 2013; 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.