Active NPI
Shannon Nichole Baisden, MA
- Health & Wellness Coach
- Mission, KS
National Provider Identifier
1609542828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- License
- W46011
- Practice address
- 6130 Hodges Dr
Mission, KS 66205-3038 - Phone
- (913) 645-5675
- NPI assigned
- Aug 18, 2021
- Last updated
- Aug 18, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Exercise Physiologist | 224Y00000X | 1180234454 | ||
| Health & Wellness Coach | 171400000X | W46011 | KS | Primary |
Addresses
Primary practice location
6130 Hodges Dr
Mission, KS 66205-3038
Mailing address
6130 Hodges Dr
Mission, KS 66205-3038
Phone (913) 645-5675
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| W46011 | KS | MD | Health & Wellness Coach |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629244800000",
"number": "1609542828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6130 HODGES DR",
"city": "MISSION",
"state": "KS",
"postal_code": "662053038",
"telephone_number": "913-645-5675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6130 HODGES DR",
"city": "MISSION",
"state": "KS",
"postal_code": "662053038",
"telephone_number": "913-645-5675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAISDEN",
"first_name": "SHANNON",
"middle_name": "NICHOLE",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-18",
"last_updated": "2021-08-18",
"certification_date": "2021-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "224Y00000X",
"taxonomy_group": "",
"desc": "Clinical Exercise Physiologist",
"state": null,
"license": "1180234454",
"primary": false
},
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": "KS",
"license": "W46011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.