Active NPI
Jonathan Anderson, LMFT
- Marriage & Family Therapist
- Wichita, KS
National Provider Identifier
1699042697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1049
- Practice address
- 5900 E Central Ave
Suite 101
Wichita, KS 67208-4240 - Phone
- (316) 425-7774
- Fax
- (316) 425-7779
- NPI assigned
- Nov 19, 2011
- Last updated
- Dec 5, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1049 | KS | Primary |
Addresses
Primary practice location
5900 E Central Ave
Suite 101
Wichita, KS 67208-4240
Mailing address
5900 E Central Ave
Suite 101
Wichita, KS 67208-4240
Phone (316) 425-7774
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200750620A | Medicaid | KS |
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 |
|---|---|---|---|
| 1049 | KS | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354665600000",
"number": "1699042697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 E CENTRAL AVE",
"address_2": "SUITE 101",
"city": "WICHITA",
"state": "KS",
"postal_code": "672084240",
"telephone_number": "316-425-7774",
"fax_number": "316-425-7779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 E CENTRAL AVE",
"address_2": "SUITE 101",
"city": "WICHITA",
"state": "KS",
"postal_code": "672084240",
"telephone_number": "316-425-7774",
"fax_number": "316-425-7779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JONATHAN",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-11-19",
"last_updated": "2012-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "KS",
"license": "1049",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200750620A",
"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 Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.