NPIMap

Organization Active NPI

Changing Habits

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Wichita, KS
National Provider Identifier
1871833285
Registry record updated Dec 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
07570128 Issued in KS
Legal business name
CHANGING HABITS
Practice address
1115 S Glendale St Ste 204
Parklane Shopping Center Lower Level
Wichita, KS 67218-3232
Phone
(316) 409-5242
Fax
(316) 719-2440
NPI assigned
Feb 21, 2013
Last updated
Dec 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2015

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

Authorized official

Name
Mr. David Brian Simmons, LACNPI 1205194099
Title
Owner
Phone
(316) 409-5242

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 07570128 KS Primary

Addresses

Primary practice location

1115 S Glendale St Ste 204
Parklane Shopping Center Lower Level
Wichita, KS 67218-3232

Mailing address

1115 S Glendale St Ste 204
Parklane Shopping Center Lower Level
Wichita, KS 67218-3232
Phone (316) 409-5242

National Provider Directory

National Provider Directory

Locations

1115 S Glendale St
Ste 204
Wichita, KS 67218
Phone (316) 409-5242

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450742400000",
    "number": "1871833285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 S GLENDALE ST STE 204",
            "address_2": "PARKLANE SHOPPING CENTER LOWER LEVEL",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672183232",
            "telephone_number": "316-409-5242",
            "fax_number": "316-719-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S GLENDALE ST STE 204",
            "address_2": "PARKLANE SHOPPING CENTER LOWER LEVEL",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672183232",
            "telephone_number": "316-409-5242",
            "fax_number": "316-719-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING HABITS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-21",
        "last_updated": "2015-12-22",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-409-5242",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "KS",
            "license": "07570128",
            "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 Dec 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.