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MR. CECIL J FACKRELL PA-C
NPI 1174646400
Physician Assistant in Shawnee, KS

Active since April 10, 2007
6333 LONG AVE, SUITE 360, SHAWNEE, KS 66216(913) 631-6330(913) 631-6222 Get Directions Write a Review

NPPES record last updated: March 15, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 15, 2017, Jan 18, 2017 (2 updates tracked since 2017).

About Mr. Cecil J Fackrell Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. CECIL J FACKRELL PA-C (NPI 1174646400) is an individual physician assistant in Shawnee, Kansas, licensed in Kansas (15-01306) and active in the NPI registry since April 2007.

NPPES Registry Identity

NPI1174646400
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameMR. CECIL J FACKRELLCredential: PA-C
Location Address6333 LONG AVE, SUITE 360Shawnee, KS 66216-2500
Mailing Address6333 Long Ave, Suite 360Shawnee, KS 66216-2500 · (913) 631-6330 · Fax (913) 631-6222
Phone(913) 631-6330
Fax(913) 631-6222
Sole ProprietorNo
Enumeration DateApril 10, 2007
Last NPPES UpdateMarch 15, 20172 updates tracked since enumeration
✔ NPI 1174646400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in KS · 15-01306
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
6333 LONG AVE, Shawnee, KS 66216
Open in Google Maps ↗

Other Identifiers 1

Medicare PIN110426047KS

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMERICAN DERMATOLOGY ASSOCIATES, LLC
Dermatology
6333 LONG AVE, SUITE 360
SHAWNEE MISSION, KS 66216
Johnson County (913) 631-6330

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cecil Fackrell's NPI number?

The NPI number for Cecil Fackrell is 1174646400. It was assigned to this individual provider in the NPPES registry on April 10, 2007.

Where is Cecil Fackrell located?

Cecil Fackrell practices at 6333 Long Ave Suite 360, Shawnee, KS 66216. The listed phone number is (913) 631-6330.

What is Cecil Fackrell's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Cecil Fackrell was last updated on March 15, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.