Active NPI
Justen Blare Crane, OT
- Occupational Therapist
- Wichita, KS
National Provider Identifier
1881368314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- T-05645
- Practice address
- 10665 W 13TH St N
Wichita, KS 67212-5600 - Phone
- (316) 285-1348
- NPI assigned
- Aug 7, 2021
- Last updated
- Aug 7, 2021
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | T-05645 | KS | Primary |
Addresses
Primary practice location
10665 W 13TH St N
Wichita, KS 67212-5600
Mailing address
237 S Grand Mere CT
Wichita, KS 67230-6428
Phone (316) 304-8786
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628294400000",
"number": "1881368314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "237 S GRAND MERE CT",
"city": "WICHITA",
"state": "KS",
"postal_code": "672306428",
"telephone_number": "316-304-8786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10665 W 13TH ST N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672125600",
"telephone_number": "316-285-1348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRANE",
"first_name": "JUSTEN",
"middle_name": "BLARE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-07",
"last_updated": "2021-08-07",
"certification_date": "2021-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KS",
"license": "T-05645",
"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 Aug 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.