Active NPI
Jesse Pearson, CNMT
- Radiologic Technologist
- Wichita, KS
National Provider Identifier
1831621481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiologic Technologist
- License
- 22-02994
- Practice address
- 2522 N Fox Run CT
Wichita, KS 67226-3605 - Phone
- (605) 261-0294
- NPI assigned
- Apr 3, 2017
- 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 |
|---|---|---|---|---|
| Radiologic Technologist | 247100000X | 22-02994 | KS | Primary |
Addresses
Primary practice location
2522 N Fox Run CT
Wichita, KS 67226-3605
Mailing address
2522 N Fox Run CT
Wichita, KS 67226-3605
Phone (605) 261-0294
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 |
|---|---|---|---|
| 22-02994 | KS | MD | Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491177600000",
"number": "1831621481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2522 N FOX RUN CT",
"city": "WICHITA",
"state": "KS",
"postal_code": "672263605",
"telephone_number": "605-261-0294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2522 N FOX RUN CT",
"city": "WICHITA",
"state": "KS",
"postal_code": "672263605",
"telephone_number": "605-261-0294"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "JESSE",
"credential": "CNMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-03",
"last_updated": "2017-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "247100000X",
"taxonomy_group": "",
"desc": "Radiologic Technologist",
"state": "KS",
"license": "22-02994",
"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 Apr 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.