Active NPI
Michael Pauldine
- Clinical Psychologist
- Newton, KS
National Provider Identifier
1407223522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2650
- Practice address
- 1901 E 1St St
Newton, KS 67114-5010 - Phone
- (316) 284-6400
- NPI assigned
- Aug 24, 2015
- Last updated
- Aug 24, 2015
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2650 | KS | Primary |
Addresses
Primary practice location
1901 E 1St St
Newton, KS 67114-5010
Mailing address
737 S Oliver Ave
Wichita, KS 67218-2344
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 |
|---|---|---|---|
| 2650 | KS | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440374400000",
"number": "1407223522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "737 S OLIVER AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "672182344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 E 1ST ST",
"city": "NEWTON",
"state": "KS",
"postal_code": "671145010",
"telephone_number": "316-284-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULDINE",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-08-24",
"last_updated": "2015-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "2650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newton, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.