NPIMap

Individual provider Active NPI

Wayne C Piersel, PHD PSYCHOLOGY

  • Psychologist
  • Wichita, KS
National Provider Identifier
1457448201
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1051 Issued in KS
Practice address
8700 E 29TH Street North
Wichita, KS 67226-2169
Phone
(316) 634-8710
Fax
(316) 634-8850
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 1051 KS
Clinical Psychologist 103TC0700X 1051 KS
Counseling Psychologist 103TC1900X 1051 KS
Clinical Child & Adolescent Psychologist 103TC2200X 1051 KS
Family Psychologist 103TF0000X 1051 KS
Intellectual & Developmental Disabilities Psychologist 103TM1800X 1051 KS
Psychologist 103T00000X 1051 KS Primary
School Psychologist 103TS0200X 1051 KS

Addresses

Primary practice location

8700 E 29TH Street North
Wichita, KS 67226-2169

Mailing address

8700 E 29TH Street North
Wichita, KS 67226-2169
Phone (316) 634-8710

Other identifiers 2

IdentifierTypeStateIssuer
119040OtherKSBCBS
12555OtherKSPHS

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1051KSMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1457448201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 E 29TH STREET NORTH",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262169",
            "telephone_number": "316-634-8710",
            "fax_number": "316-634-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 E 29TH STREET NORTH",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262169",
            "telephone_number": "316-634-8710",
            "fax_number": "316-634-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERSEL",
        "first_name": "WAYNE",
        "middle_name": "C",
        "credential": "PHD PSYCHOLOGY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "KS",
            "license": "1051",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "1051",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "KS",
            "license": "1051",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "KS",
            "license": "1051",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "KS",
            "license": "1051",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "KS",
            "license": "1051",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "1051",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "KS",
            "license": "1051",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "119040",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHS",
            "identifier": "12555",
            "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 Sep 5, 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.

Verify at the official NPI Registry.