MR. CECIL J FACKRELL (NPI# 1174646400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174646400 |
| Entity Type | Individual |
| Full Name | MR. CECIL J FACKRELL |
| Credential | PA-C |
| Practice Address |
6333 Long Ave Suite 360 Shawnee KS 66216-2500 |
| Practice Telephone | 9136316330 |
| Practice Fax Number | 9136316222 |
| Mailing Telephone | 9136316330 |
| Mailing Fax Number | 9136316222 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2017-03-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 15-01306 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6333 LONG AVE SUITE 360 |
| City | SHAWNEE |
| State | KS |
| Zip Code | 66216-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831648112 | Courtney L Stene | Physician Assistant | 6333 Long Ave, Shawnee, KS 66216-2500 | 2016-09-27 |
| 1275700528 | Meena Kumari Singh | Dermatology | 6333 Long Ave, Suite 360, Shawnee, KS 66216-2500 | 2008-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912431925 | Sara Fattaey | Social Worker | 7020 Constance St, Shawnee, KS 66216 | 2017-04-17 |
| 1952778631 | Martin Gale Volker | Pharmacist | 13550 W 63rd Street, Shawnee, KS 66216 | 2015-08-28 |
| 1952799827 | Susan Thomure | Physical Therapy Assistant | 6401 Long, Shawnee, KS 66216 | 2014-12-31 |
| 1144594326 | Tom Wigginton Medical, Inc. | Durable Medical Equipment & Medical Supplies | 12616 W 62nd Terr., Suite 115c, Shawnee, KS 66216 | 2012-03-06 |
| 1548572811 | Tyler Ross Young | Optometrist | 12129 Shawnee Mission Pkwy, Shawnee, KS 66216 | 2010-07-02 |
| 1689801441 | Charles Richard Ford | Ophthalmology | 4742 Black Swan Drive, Shawnee, KS 66216 | 2009-06-18 |
| 1659412237 | Carol J. Akers | Dentist | 12480 W 62nd Ter Ste 200, Shawnee, KS 66216 | 2007-02-08 |
| 1699788307 | Douglas A Anderson | Chiropractor | 12510 W 62nd Terrace, Ste #101, Shawnee, KS 66216 | 2006-08-14 |
| 1861442451 | Dayna M Brinckman | Dentist | 7407 Noland Rd, Shawnee, KS 66216 | 2006-05-12 |
| 1932164894 | Vintage Park At Lenexa LLC | Assisted Living Facility | 8710 Caenen Lake Road, Lenexa, KS 66216 | 2006-04-20 |
| Find all providers in zip 66216 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952897621 | Kelsey Rae Nehrig | Physician Assistant | 7420 Switzer Road, Shawnee, KS 66203 | 2018-07-06 |
| 1689850836 | Adam D. Hogue | Physician Assistant | 1501 N Airport Dr, Shawnee, OK 74804-4321 | 2008-01-18 |
| 1255492633 | Stephanie Lynn Caldwell | Physician Assistant | 7405 Renner Road, Shawnee, KS 66217 | 2006-12-12 |
| 1194811620 | William Schmidt | Physician Assistant | 6850 Hilltop Road, Suite 170, Shawnee, KS 66226 | 2006-10-04 |
| 1841397270 | Stephanie E Painter | Physician Assistant | 15440 W 65th St, Shawnee, KS 66217-9306 | 2006-09-20 |
| 1639192446 | Jaime Ann Johnson | Physician Assistant | 2506 N Harrison St, Shawnee, OK 74804 | 2006-07-25 |
| 1043257165 | Cary Douglas Nation | Physician Assistant | 1501 Airport Dr, Shawnee, OK 74804-4321 | 2006-05-31 |
| 1891761102 | Robert B Swatek | Physician Assistant | 5949 Nieman Rd, Shawnee, KS 66203-2930 | 2006-02-27 |
| 1588209423 | Murphi E Sparkman | Physician Assistant | 781 Grand Casino Blvd, Shawnee, OK 74804-1005 | 2019-11-14 |
| 1124513809 | Jared Conatser | Physician Assistant | 12 E Macarthur St, Shawnee, OK 74804-2135 | 2018-06-26 |
| Find all providers in SHAWNEE | ||||
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| 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.