Active NPI
Douglas Allen Mathiesen, DC
- Chiropractor
- Shawnee, KS
National Provider Identifier
1457368102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 0103764
- Practice address
- 5900 Nieman Rd
Suite 300
Shawnee, KS 66203-2936 - Phone
- (913) 631-7900
- Fax
- (913) 268-0908
- NPI assigned
- Aug 2, 2006
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0103764 | KS | Primary |
Addresses
Primary practice location
5900 Nieman Rd
Suite 300
Shawnee, KS 66203-2936
Mailing address
5900 Nieman Rd
Suite 300
Shawnee, KS 66203-2936
Phone (913) 631-7900
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0103764 | KS | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457368102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 NIEMAN RD",
"address_2": "SUITE 300",
"city": "SHAWNEE",
"state": "KS",
"postal_code": "662032936",
"telephone_number": "913-631-7900",
"fax_number": "913-268-0908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 NIEMAN RD",
"address_2": "SUITE 300",
"city": "SHAWNEE",
"state": "KS",
"postal_code": "662032936",
"telephone_number": "913-631-7900",
"fax_number": "913-268-0908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHIESEN",
"first_name": "DOUGLAS",
"middle_name": "ALLEN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KS",
"license": "0103764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shawnee, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.