Individual provider Active NPI

Audrey Elizabeth Tullis, D.C.

  • Chiropractor
  • Parsons, KS
National Provider Identifier
1780969733
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05407 Issued in KS
Practice address
3528 Main St
Parsons, KS 67357-3637
Phone
(620) 717-2734
NPI assigned
Oct 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05407 KS Primary

Addresses

Primary practice location

3528 Main St
Parsons, KS 67357-3637

Mailing address

3528 Main St
Parsons, KS 67357-3637
Phone (620) 717-2734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120223000577 KS Practitioner - Chiropractic 9234397142 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2431 Main St
Parsons, KS 67357-2725
Phone (620) 717-4152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Null Chiropractic LLC Chiropractor CurrentSince Jan 30, 2013 Accepting new patients
Tullis Custom Chiropractic & Holistic Health LLC Chiropractor CurrentSince May 25, 2013 Accepting new patients

Locations

204 E Chestnut St
Independence, KS 67301
Phone (620) 331-1520

2431 Main St
Parsons, KS 67357
Phone (620) 421-2790

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1780969733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3528 MAIN ST",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "673573637",
            "telephone_number": "620-717-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3528 MAIN ST",
            "city": "PARSONS",
            "state": "KS",
            "postal_code": "673573637",
            "telephone_number": "620-717-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLIS",
        "first_name": "AUDREY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parsons, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.