Active NPI
Jim Dow Persinger
- School Psychologist
- Emporia, KS
National Provider Identifier
1962018853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 36557
- Practice address
- 1 Kellogg Cir
Emporia, KS 66801-5415 - Phone
- (620) 341-5317
- NPI assigned
- Sep 16, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 36557 | MD | Primary |
Addresses
Primary practice location
1 Kellogg Cir
Emporia, KS 66801-5415
Mailing address
4213 Briarwood Dr
Lawrence, KS 66049-1998
Phone (620) 794-1778
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36557 | MD | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600214400000",
"number": "1962018853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4213 BRIARWOOD DR",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660491998",
"telephone_number": "620-794-1778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 KELLOGG CIR",
"city": "EMPORIA",
"state": "KS",
"postal_code": "668015415",
"telephone_number": "620-341-5317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERSINGER",
"first_name": "JIM",
"middle_name": "DOW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-16",
"last_updated": "2020-09-16",
"certification_date": "2020-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "MD",
"license": "36557",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Emporia, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.