Shaley Knickerbocker

Primary specialty

Emergency Registered NurseTaxonomy code 163WE0003X

License

138424 Issued in KS

Practice address

9100 W 74TH St
Shawnee Mission, KS 66204-4004

Phone

(913) 676-7400

NPI assigned

Nov 13, 2024

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1962226126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 FLAME WAY",
            "city": "BALDWIN CITY",
            "state": "KS",
            "postal_code": "660064168",
            "telephone_number": "785-443-0834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 W 74TH ST",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662044004",
            "telephone_number": "913-676-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNICKERBOCKER",
        "first_name": "SHALEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "KS",
            "license": "138424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua L Kiene
• Deborah A King
• Mary Anne Kiser, LCMFT
• Stephanie Anne Klamm, CRNA
• Darcey Klein, OTR/L
• Anastasia Marie Kohlrus, MD
• KP Medical Billing Services
• Jay H. Kraenow, CRNA
• Holly Krause
• Bradley Raymond Kwapiszeski, M.D.

• Emergency Registered Nurse in Shawnee Mission, KS
• Providers in Shawnee Mission, KS by specialty
• Emergency Registered Nurse in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.