Active NPI
Jerry R Nossaman, D.D.S.
- Dentist
- Lawrence, KS
National Provider Identifier
1730116237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4549
- Practice address
- 831 Vermont St
Lawrence, KS 66044-2665 - Phone
- (785) 843-6060
- Fax
- (785) 843-4335
- NPI assigned
- Jun 28, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4549 | KS | Primary |
Addresses
Primary practice location
831 Vermont St
Lawrence, KS 66044-2665
Mailing address
1116 West Hills Pkwy
Lawrence, KS 66044
Phone (785) 842-7181
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36600015 | Other | KS | BCBS OF KC |
| 116938 | Other | KS | BCBS OF 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 |
|---|---|---|---|
| 4549 | KS | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730116237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1116 WEST HILLS PKWY",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "66044",
"telephone_number": "785-842-7181",
"fax_number": "785-843-4335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "831 VERMONT ST",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660442665",
"telephone_number": "785-843-6060",
"fax_number": "785-843-4335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOSSAMAN",
"first_name": "JERRY",
"middle_name": "R",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KS",
"license": "4549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF KC",
"identifier": "36600015",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF KS",
"identifier": "116938",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.