Organization Active NPI

Gulledge Family Wellness P.a.

  • Pediatric Chiropractor
  • Overland Park, KS
National Provider Identifier
1568735173
Registry record updated Oct 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric ChiropractorTaxonomy code 111NP0017X
License
01-05311 Issued in KS
Legal business name
GULLEDGE FAMILY WELLNESS P.A.
Practice address
11879 W 112TH St
Suite 100
Overland Park, KS 66210-2725
Phone
(913) 338-1112
Fax
(913) 338-2079
NPI assigned
Feb 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2013

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

Authorized official

Name
Dr. Jill Marie Strom Gulledge, DC
Title
Chiropractor
Phone
(913) 338-1112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NP0017X 01-05311 KS Primary

Addresses

Primary practice location

11879 W 112TH St
Suite 100
Overland Park, KS 66210-2725

Mailing address

11879 W 112TH St
Suite 100
Overland Park, KS 66210-2725
Phone (913) 338-1112

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1329091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382400000000",
    "number": "1568735173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11879 W 112TH ST",
            "address_2": "SUITE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102725",
            "telephone_number": "913-338-1112",
            "fax_number": "913-338-2079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11879 W 112TH ST",
            "address_2": "SUITE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662102725",
            "telephone_number": "913-338-1112",
            "fax_number": "913-338-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULLEDGE FAMILY WELLNESS P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-13",
        "last_updated": "2013-10-22",
        "status": "A",
        "authorized_official_last_name": "GULLEDGE",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "MARIE STROM",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "913-338-1112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "KS",
            "license": "01-05311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.