=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811094196
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOPEKA PUBLIC SCHOOLS USD 501
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2006
-----------------------------------------------------
Last Update Date | 07/23/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 624 SW 24TH ST
-----------------------------------------------------
City | TOPEKA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66611-1294
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 785-235-7600
-----------------------------------------------------
Fax | 785-575-6112
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 189
-----------------------------------------------------
City | GIRARD
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66743-0189
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-724-6281
-----------------------------------------------------
Fax | 620-724-7141
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF SPECIAL EDUCATION K-12
-----------------------------------------------------
Name | DR. ROBERT WITTMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 785-235-7600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QS1000X
-----------------------------------------------------
Taxonomy Name | Student Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------