COLLEGE PARK ANCILLARY, LLC (NPI# 1356617757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356617757 |
| Entity Type | Organization |
| Organization Name | COLLEGE PARK ANCILLARY, LLC |
| Other Organization Name | COLLEGE PARK PHYSICAL THERAPY |
| Practice Address |
10600 Mastin St Overland Park KS 66212-5723 |
| Mailing Address |
Po Box 742554 Atlanta GA 30374-2105 |
| Practice Telephone | 9136810606 |
| Practice Fax Number | 9133381311 |
| Mailing Telephone | 9134690503 |
| Mailing Fax Number | 9134695267 |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2013-10-11 |
| Authorized Official Name | CHARLES O CHAMBERS (ADMINISTRATOR) |
| Authorized Official Telephone | 9134690503 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| College Park Physical Therapy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508203241 | College Park Ancillary, LLC | Clinic/Center | 10600 Mastin St, Overland Park, KS 66212-5723 | 2013-06-03 |
| Street Address |
10600 MASTIN ST |
| City | OVERLAND PARK |
| State | KS |
| Zip Code | 66212-5723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487657409 | Robert L Pierron | Orthopaedic Surgery | 10600 Mastin St, Overland Park, KS 66212-5723 | 2005-05-23 |
| 1821601931 | Katelyn Gibbons | Physical Therapist | 10600 Mastin St, Overland Park, KS 66212-5723 | 2020-08-28 |
| 1043850720 | Andrew Cozart | Physical Therapist | 10600 Mastin St, Overland Park, KS 66212-5723 | 2020-01-10 |
| 1659916963 | Olyvia Faith Engelhardt | Physical Therapy Assistant | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-11-11 |
| 1902440035 | Shane Marcus Wilson | Physical Therapy Assistant | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-11-01 |
| 1760026769 | Adrianna H Jensen | Physical Therapy Assistant | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-11-01 |
| 1497399406 | Elizabeth Anne Ashley | Physical Therapy Assistant | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-11-01 |
| 1437709615 | Lscm, LLC | Physical Therapist | 10600 Mastin St, Entrance B Attn: Shelley Lewis, Overland Park, KS 66212-5723 | 2019-09-19 |
| 1982266714 | Jacob C Crist | Physical Therapist | 10600 Mastin St, Overland Park, KS 66212-5723 | 2019-07-02 |
| 1669948618 | Brooke Katterhenry | Physical Therapist | 10600 Mastin St, Overland Park, KS 66212-5723 | 2018-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598363137 | Marva Calder | Nurse Practitioner | 7299 W 98th Terrance Bld 6, Suite 120, Overland Park, KS 66212 | 2020-10-15 |
| 1518572163 | Pathways To Empowerment | Marriage & Family Therapist | 7180 W. 107th Street, St. 21, Overland Park, KS 66212 | 2020-09-10 |
| 1689287914 | Lisa Marie Ambrosek | Behavioral Analyst | 7725 W 87th Street, Overland Park, KS 66212 | 2020-08-26 |
| 1598221061 | Ginger Marie Anderson | Massage Therapist | 9200 Glewood Street Suite 101, Overland Park, KS 66212 | 2019-02-20 |
| 1508335092 | Samantha Nicole Stevens | Behavior Technician | 7725 W. 87th Street, Overland Park, KS 66212 | 2018-11-14 |
| 1831600360 | Kristin Nichols | Occupational Therapist | 8826 Sante Fe Dr, Suite 203, Overland Park, KS 66212 | 2017-10-24 |
| 1538529003 | Cindy Sykes | Social Worker | 8402 Lowell Ave, Overland Park, KS 66212 | 2016-02-26 |
| 1265804157 | Lauren Spears | Psychologist | 10100 W 87th St Ste 306, Overland Park, KS 66212 | 2015-10-30 |
| 1699158279 | Harbor Hospice of Kansas Lp | Hospice Care, Community Based | 7223 W 95th St Ste 230, Overland Park, KS 66212 | 2015-07-01 |
| 1982000303 | Doolittle & Harrington Healthcare LLC | Clinic/Center | 10560 Barkley St Ste 340, Overland Park, KS 66212 | 2014-11-12 |
| Find all providers in zip 66212 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487160255 | Femme Focus, L.L.C. | Clinic/Center | 7927 Floyd, Rm 5, Home Family Holistic Center, Overland Park, KS 66204 | 2017-12-15 |
| 1720338098 | Bsp Kansas | Clinic/Center | 16052 Foster Street, Overland Park, KS 66085 | 2012-09-14 |
| 1487903951 | Bsp Kansas LLC | Clinic/Center | 16052 Foster St, Overland Park, KS 66085-8876 | 2012-08-30 |
| 1134396088 | Specialists In Orthopedic and Athletic Rehabilitation LLC | Clinic/Center | 14868 Metcalf Ave, Overland Park, KS 66223-2206 | 2008-05-09 |
| 1447377015 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 6555 W 75th St, Apt #3, Overland Park, KS 66204-3023 | 2007-03-26 |
| 1003961533 | Associated Physical Therapists of Kansas,pa | Clinic/Center | 9391 W 75th St, Overland Park, KS 66204-2231 | 2007-01-24 |
| 1538184536 | Performance Rehab, LLC | Clinic/Center | 11504 West 135th Street, Overland Park, KS 66221-3760 | 2006-07-12 |
| 1053368621 | Arc Overland Park LLC | Clinic/Center | 9201 Foster St, Overland Park, KS 66212-2295 | 2006-05-28 |
| 1811941479 | Advanced Physical Therapy and Sports Rehabilitation, Pa | Clinic/Center | 10740 Nall Ave Ste 215, Overland Park, KS 66211-1296 | 2006-05-19 |
| 1780060160 | Logan Hubbard | Clinic/Center | 13800 Metcalf Ave, Overland Park, KS 66223-1200 | 2015-08-07 |
| Find all providers in OVERLAND PARK | ||||
| City | OVERLAND PARK |
| Zip Code | 66212 |
Please comment or provide details below to improve the information on COLLEGE PARK ANCILLARY, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.