Active NPI
Larry Wayne Wilson
- Hearing Instrument Specialist
- Kansas City, MO
National Provider Identifier
1497829089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 001255
- Practice address
- 4240 Blue Ridge Blvd
#510
Kansas City, MO 64133-1713 - Phone
- (913) 766-4888
- Fax
- (913) 766-4889
- NPI assigned
- Nov 17, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 001255 | MO | Primary |
| Hearing Instrument Specialist | 237700000X | 1480 | KS |
Addresses
Primary practice location
4240 Blue Ridge Blvd
#510
Kansas City, MO 64133-1713
Mailing address
2040 Hutton Rd
#108
Kansas City, KS 66109
Phone (913) 766-4888
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 |
|---|---|---|---|
| 1480 | KS | MD | Registered Dietitian |
| 001255 | MO | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freedom Hearing | Hearing Instrument Specialist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491523200000",
"number": "1497829089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2040 HUTTON RD",
"address_2": "#108",
"city": "KANSAS CITY",
"state": "KS",
"postal_code": "66109",
"telephone_number": "913-766-4888",
"fax_number": "913-766-4889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4240 BLUE RIDGE BLVD",
"address_2": "#510",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641331713",
"telephone_number": "913-766-4888",
"fax_number": "913-766-4889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "LARRY",
"middle_name": "WAYNE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-17",
"last_updated": "2017-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "MO",
"license": "001255",
"primary": true
},
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "KS",
"license": "1480",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.