Jason Fanselau, CNIM

Primary specialty

Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X

Practice address

128 W 13TH St
Apt 1011
Kansas City, MO 64105-1726

Phone

(972) 489-6170

NPI assigned

Apr 22, 2016

Last updated

Apr 22, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461283200000",
    "number": "1942654280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 W 13TH ST",
            "address_2": "APT 1011",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641051726",
            "telephone_number": "972-489-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W 13TH ST",
            "address_2": "APT 1011",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641051726",
            "telephone_number": "972-489-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANSELAU",
        "first_name": "JASON",
        "credential": "CNIM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2016-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Foot Care Clinic, LLC
• Family Solutions Counseling
• Family Solutions Services, LLC
• Anthony L. Fangman, M.D.
• Christina Fangman, DDS
• Casie M Fansher
• Sarah Fantus, M.D.
• Asha H Farah
• Hana Farah
• Samatar Farah

• Electroneurodiagnostic Specialist/Technologist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Electroneurodiagnostic Specialist/Technologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2016; 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.