Individual provider Active NPI

Kristen Marie Sibold, OTR

  • Occupational Therapist
  • Overland Park, KS
National Provider Identifier
1104049477
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
17-02357 Issued in KS
Practice address
10590 Barkley St
Suite 330
Overland Park, KS 66212-1811
Phone
(913) 652-9225
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 17-02357 KS Primary
Occupational Therapist 225X00000X 01578 IA
Occupational Therapist 225X00000X 2006015503 MO

Addresses

Primary practice location

10590 Barkley St
Suite 330
Overland Park, KS 66212-1811

Mailing address

10354 Goddard St
Apt. 194
Overland Park, KS 66214-3000
Phone (913) 660-6842

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
01578IAMDOptometrist
17-02357KSMDOccupational Therapist
2006015503MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104049477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10354 GODDARD ST",
            "address_2": "APT. 194",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662143000",
            "telephone_number": "913-660-6842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 BARKLEY ST",
            "address_2": "SUITE 330",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121811",
            "telephone_number": "913-652-9225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBOLD",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-02357",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "01578",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2006015503",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.