Active NPI
Mary K. Noller, P.T.
- Pediatric Physical Therapist
- Wichita, KS
National Provider Identifier
1760690861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 11-00732
- Practice address
- 929 N Saint Francis St
Wichita, KS 67214-3821 - Phone
- (316) 268-8200
- NPI assigned
- May 20, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 11-00732 | KS | Primary |
Addresses
Primary practice location
929 N Saint Francis St
Wichita, KS 67214-3821
Mailing address
1504 S Springhollow Cir
Wichita, KS 67230-9100
Phone (316) 733-1125
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 |
|---|---|---|---|
| 11-00732 | KS | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760690861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1504 S SPRINGHOLLOW CIR",
"city": "WICHITA",
"state": "KS",
"postal_code": "672309100",
"telephone_number": "316-733-1125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "929 N SAINT FRANCIS ST",
"city": "WICHITA",
"state": "KS",
"postal_code": "672143821",
"telephone_number": "316-268-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLLER",
"first_name": "MARY",
"middle_name": "K.",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "KS",
"license": "11-00732",
"primary": true
}
],
"identifiers": [],
"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 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.