Active NPI
Dakota Chase Ecklund
- Licensed Practical Nurse
- Derby, KS
National Provider Identifier
1376310979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 23-51030-061
- Practice address
- 510 S Westview Dr
Derby, KS 67037-1340 - Phone
- (316) 869-6961
- NPI assigned
- Dec 5, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 23-51030-061 | KS | Primary |
Addresses
Primary practice location
510 S Westview Dr
Derby, KS 67037-1340
Mailing address
2012 S Edmunds St
Seattle, WA 98108-1927
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
| License | State | Type | Specialty |
|---|---|---|---|
| 23-51030-061 | KS | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701734400000",
"number": "1376310979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2012 S EDMUNDS ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981081927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 S WESTVIEW DR",
"city": "DERBY",
"state": "KS",
"postal_code": "670371340",
"telephone_number": "316-869-6961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKLUND",
"first_name": "DAKOTA",
"middle_name": "CHASE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-12-05",
"last_updated": "2023-12-05",
"certification_date": "2023-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "KS",
"license": "23-51030-061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Derby, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.