Look up the most recent NPI and PECOS records

Telisa L Purdy

Counselor

Behavioral Health & Social Service Providers

PECOS Enrollment

This provider is enrolled in PECOS as TELISA PURDY.

Based on the most recent information from CMS, provider Telisa L Purdy 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
1770728537
Provider Type
Individual
Full Name
Purdy, Telisa L
Credential
LMLP

Gender
Female
Sole Proprietor
No
Enumeration Date
12/9/2008
Last Updated
2/19/2013

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 LMLP 806 Kansas

Provider Identifiers

ID	Description	Issuer
ID 200587040A	Description Medicaid	Issuer Unlisted Kansas

Telisa L Purdy

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

Main, Sydney

Kinzer, Emily H

Sunflower Centers Of Kansas, Inc

Huffman, Robin L

Lauterbach, Amy Lyn

Cordts, Barbara A

Heyveld, Ryan

Walter, David

Waddle, Elizabeth

Wacker, Amy