Active NPI
Amy C Antle, D.C.
- Chiropractor
- Great Bend, KS
National Provider Identifier
1952494809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 04561
- Practice address
- 1005 Williams St
Great Bend, KS 67530-4474 - Phone
- (316) 215-1584
- NPI assigned
- Oct 2, 2006
- Last updated
- Apr 19, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 04561 | KS | Primary |
Addresses
Primary practice location
1005 Williams St
Great Bend, KS 67530-4474
Mailing address
205 Grandview Ave
Newton, KS 67114-2045
Phone (316) 215-1584
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| KA1715 | Other | KS | PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041115000855 | KS | Practitioner - Chiropractic | 0446214936 | Practice locations: Great Bend, KS |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Los Angeles College of Chiropractic, 1998
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1105 Main St
Suite a
Great Bend, KS 67530-4471
Phone (316) 215-1584
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04561 | KS | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681862400000",
"number": "1952494809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 GRANDVIEW AVE",
"city": "NEWTON",
"state": "KS",
"postal_code": "671142045",
"telephone_number": "316-215-1584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 WILLIAMS ST",
"city": "GREAT BEND",
"state": "KS",
"postal_code": "675304474",
"telephone_number": "316-215-1584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTLE",
"first_name": "AMY",
"middle_name": "C",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-02",
"last_updated": "2023-04-19",
"certification_date": "2023-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KS",
"license": "04561",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "KA1715",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Great Bend, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.