PROFESSIONAL PHYSICALS LLC NPI 1548313471

NPI Information

  • NPI: 1548313471
  • Provider Name: PROFESSIONAL PHYSICALS, LLC
  • Classification: Registered Nurse - 163WD0400X
  • Specialization: Diabetes Educator
  • Entity Type: Organization
  • Address: 2045 12TH STREET
    SEVERY, KS
    ZIP 67137
  • Phone: (620) 736-2639

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NPI Details

PROFESSIONAL PHYSICALS, LLC is a diabetes educator registered nurse in Severy, KS. PROFESSIONAL PHYSICALS, LLC NPI is 1548313471. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2045 12TH STREET
SEVERY, KS
ZIP 67137-093
Phone: (620) 736-2639
Fax: (620) 736-2639

The provider's authorized official is Tandy Suzanne Noeller .
The authorized official title is Owner and has the following contact phone number (620) 736-2639.

The enumeration date for this NPI number is 1/22/2007 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered Nurse13-33753-081KANSASNo
2163WC1600XRegistered NurseContinuing Education/Staff Development13-33753-081KANSASNo
3163WC3500XRegistered NurseCardiac Rehabilitation13-33753-081KANSASNo
4163WW0000XRegistered NurseWound Care13-33753-081KANSASNo
5363L00000XNurse Practitioner44916KANSASNo
6363LF0000XNurse PractitionerFamily44916KANSASNo
7363LX0106XNurse PractitionerOccupational Health44916KANSASNo
8364S00000XClinical Nurse Specialist74710KANSASNo
9364SF0001XClinical Nurse SpecialistFamily Health74710KANSASNo
10364SH1100XClinical Nurse SpecialistHolistic74710KANSASNo
11364SM0705XClinical Nurse SpecialistMedical-Surgical74710KANSASNo
12364SX0106XClinical Nurse SpecialistOccupational Health74710KANSASNo
13163WD0400XRegistered NurseDiabetes Educator13-33753-081KANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10000161786OTHERKANSASBCBSKS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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