Healthcare Provider Details

I. General information

NPI: 1538909536
Provider Name (Legal Business Name): ADRIAN C KAUS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 SUNSET AVE.
MANHATTAN KS
66502
US

IV. Provider business mailing address

1201 WEST PARK GROVE DRIVE
MANHATTAN KS
66503
US

V. Phone/Fax

Practice location:
  • Phone: 785-532-5568
  • Fax:
Mailing address:
  • Phone: 785-477-0363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: