Active NPI
Sandra Rader
- Physical Therapist
- Maize, KS
National Provider Identifier
1013662634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11-01057
- Practice address
- 4590 N Maize Rd Ste 2
Maize, KS 67101-8835 - Phone
- (316) 202-0963
- Fax
- (316) 202-0964
- NPI assigned
- Feb 14, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-01057 | KS | Primary |
Addresses
Primary practice location
4590 N Maize Rd Ste 2
Maize, KS 67101-8835
Mailing address
200 W Douglas Ave Ste 250
Wichita, KS 67202-3002
Phone (316) 263-0003
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11-01057 | KS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced PT, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Wichita, KS
- NPI 1356645071
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644796800000",
"number": "1013662634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W DOUGLAS AVE STE 250",
"city": "WICHITA",
"state": "KS",
"postal_code": "672023002",
"telephone_number": "316-263-0003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4590 N MAIZE RD STE 2",
"city": "MAIZE",
"state": "KS",
"postal_code": "671018835",
"telephone_number": "316-202-0963",
"fax_number": "316-202-0964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADER",
"first_name": "SANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-14",
"last_updated": "2022-02-14",
"certification_date": "2022-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-01057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maize, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.