Organization Active NPI

Changing Times 2020 Vision LLC

  • Marriage & Family Therapist
  • Manhattan, KS
National Provider Identifier
1922648021
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
CHANGING TIMES 2020 VISION LLC
Doing business as
Changing Times
Practice address
2601 Anderson Ave Ste 202
Manhattan, KS 66502-2809
Phone
(785) 422-3049
Fax
(785) 214-5018
NPI assigned
Jan 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Authorized official

Name
Kerry Clemetson
Title
Director of Billing
Phone
(913) 475-7713

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

2601 Anderson Ave Ste 202
Manhattan, KS 66502-2809

Mailing address

2601 Anderson Ave Ste 207
Manhattan, KS 66502-2809
Phone (785) 422-3049

Other identifiers 1

IdentifierTypeStateIssuer
84-4065311OtherBEHAVIORAL HEALTH

Other names 1

  • Changing Times Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL RRS Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240604003769 KS Part B Supplier - Clinic/Group Practice 0941742043 Receives reassigned benefits from 1 practitioner
Practice locations: Manhattan, KS

National Provider Directory

National Provider Directory

Locations

2601 Anderson Ave
Ste 202
Manhattan, KS 66502
Phone (316) 691-8504

2601 Anderson Ave
Ste 207
Manhattan, KS 66502

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1922648021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 ANDERSON AVE STE 207",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022809",
            "telephone_number": "785-422-3049",
            "fax_number": "785-214-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 ANDERSON AVE STE 202",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665022809",
            "telephone_number": "785-422-3049",
            "fax_number": "785-214-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING TIMES 2020 VISION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-07",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "CLEMETSON",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "913-475-7713"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIORAL HEALTH",
            "identifier": "84-4065311",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "RRS",
            "affiliation": "N",
            "endpointDescription": "Billing Service",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2601 Anderson Ave Ste 202",
            "city": "Manhattan",
            "state": "KS",
            "country_code": "US",
            "postal_code": "665022809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Changing Times",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Changing Times",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manhattan, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.