Charliey Amber Staab

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

14-02715 Issued in KS

Practice address

10000 W 75TH St Ste 250
Merriam, KS 66204-2218

Phone

(785) 577-6326

NPI assigned

Dec 13, 2013

Last updated

Oct 8, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1386892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1508287772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11307 W 65TH ST APT 102",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662035514",
            "telephone_number": "785-577-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 W 75TH ST STE 250",
            "city": "MERRIAM",
            "state": "KS",
            "postal_code": "662042218",
            "telephone_number": "785-577-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAAB",
        "first_name": "CHARLIEY",
        "middle_name": "AMBER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-13",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "KS",
            "license": "14-02715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sidney Jessica Sorrells, MA-CCC
• Vicki Lynn Sparks
• Tiffany Speck
• Joanne Speed, LCMFT
• Jeffrrey Paul Sprinkle, C.O,T.A./L
• Tra Brendon Statler, PT, DPT
• Jessica L Stegman, DPT
• Lisa Bierly Steinert, PT
• Cole J Stephens, D.C.
• Kaylee Stephens, DPT

• Physical Therapy Assistant in Merriam, KS
• Providers in Merriam, KS by specialty
• Physical Therapy Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; 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.