Individual provider Active NPI

Brice Sanner, LCMFT

  • Marriage & Family Therapist
  • Andover, KS
National Provider Identifier
1053967737
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
03105 Issued in KS
Practice address
149 S Andover Rd Ste 100
Andover, KS 67002-7935
Phone
(316) 247-3063
Fax
(316) 247-6833
NPI assigned
Aug 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 3066 KS
Marriage & Family Therapist 106H00000X 03105 KS Primary

Addresses

Primary practice location

149 S Andover Rd Ste 100
Andover, KS 67002-7935

Mailing address

PO Box 626
Andover, KS 67002-0626
Phone (316) 247-3063

Other practice location 1

1400 Terradyne Dr Ste 309
Andover, KS 67002-9264
Phone (316) 247-3063

Other practice location 2

149 S Andover Rd Ste 600
Andover, KS 67002-8064
Phone (316) 247-3063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240124003623 KS Practitioner - Clinical Social Worker 6800249079 Reassigns benefits to 1 organization
I20240131003531 KS Practitioner - Marriage and Family Therapist 6800249079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Andover Family Counseling LLCGroup PAC ID 6103180690, 4 clinicians

Practice addresses (Care Compare)

149 S Andover Rd
Suite 100
Andover, KS 67002-7935
Phone (316) 247-3063

550 N 159TH St E
Suite 101
Wichita, KS 67230-7517
Phone (316) 247-3063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3066KSMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Andover Family Counseling, LLC CurrentSince Dec 18, 2023 Accepting new patients

Locations

1400 Terradyne Dr
Ste 309
Andover, KS 67002
Phone (316) 247-3063

149 S Andover Rd
Ste 600
Andover, KS 67002
Phone (316) 247-3063

149 S Andover Rd
Ste 100
Andover, KS 67002
Phone (316) 247-3063

550 N 159th St E
Ste 101
Wichita, KS 67230
Phone (316) 247-3063

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1053967737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 626",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670020626",
            "telephone_number": "316-247-3063",
            "fax_number": "316-247-6833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 S ANDOVER RD STE 100",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670027935",
            "telephone_number": "316-247-3063",
            "fax_number": "316-247-6833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 Terradyne Dr Ste 309",
            "address_purpose": "LOCATION",
            "city": "Andover",
            "state": "KS",
            "postal_code": "670029264",
            "country_code": "US",
            "telephone_number": "316-247-3063",
            "fax_number": "316-247-6833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "149 S Andover Rd Ste 600",
            "address_purpose": "LOCATION",
            "city": "Andover",
            "state": "KS",
            "postal_code": "670028064",
            "country_code": "US",
            "telephone_number": "316-247-3063",
            "fax_number": "316-247-6833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANNER",
        "first_name": "BRICE",
        "credential": "LCMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-17",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "3066",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "03105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, KS

Sources for this page

Verify at the official NPI Registry.