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Reg A Ayres

Counselor

Behavioral Health & Social Service Providers

PECOS Enrollment

This provider is enrolled in PECOS as REG AYRES.

Based on the most recent information from CMS, provider Reg A Ayres is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:54 AM.

Profile Details

Provider ID
1659398642
Provider Type
Individual
Full Name
Ayres, Reg A
Credential
LCP

Gender
Male
Sole Proprietor
No
Enumeration Date
7/16/2006
Last Updated
2/11/2013

Contact Information

Practice Location

25955 W 327th St, Paola, KS 66071-4920

(913) 557-9096

(913) 294-9247

Mailing Location

PO Box 677, Ottawa, KS 66067-0677

(913) 557-9096

(913) 294-9247

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License LCP 073 Kansas

Provider Identifiers

ID	Description	Issuer
ID 200431840A	Description Medicaid	Issuer Unlisted Kansas

Reg A Ayres

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Huffman, Robin L

Johnson, Donna R

Waddle, Elizabeth

Kinzer, Emily H

Purdy, Telisa L

Sunflower Centers Of Kansas, Inc

Cordts, Barbara A

Bindi, Gracie

Lauterbach, Amy Lyn

Wacker, Amy