Individual provider Active NPI

Sydnee Nicole Yancey, DPT, LAT, ATC

  • Physical Therapist
  • Knob Noster, MO
National Provider Identifier
1154886778
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2024023402 Issued in MO
Practice address
106 E Lucas St
Knob Noster, MO 65336-1134
Phone
(660) 563-9800
Fax
(660) 563-9801
NPI assigned
Feb 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2021034464 MO
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X 2024023402 MO Primary

Addresses

Primary practice location

106 E Lucas St
Knob Noster, MO 65336-1134

Mailing address

106 E Lucas St
Knob Noster, MO 65336-1134
Phone (660) 563-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912001671 MO Practitioner - Physical Therapist in Private Practice 4082154497 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Missouri, Columbia School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Knob Noster Physical Therapy, LLC 5 clinicians

Practice addresses (Care Compare)

106 E Lucas St
Knob Noster, MO 65336-1134
Phone (660) 563-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2021034464MOMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Knob Noster Physical Therapy, LLC Physical Therapist CurrentSince Jul 5, 2024 Accepting new patients

Locations

106 E Lucas St
Knob Noster, MO 65336
Phone (660) 563-9800

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": "1549497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1154886778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E LUCAS ST",
            "city": "KNOB NOSTER",
            "state": "MO",
            "postal_code": "653361134",
            "telephone_number": "660-563-9800",
            "fax_number": "660-563-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E LUCAS ST",
            "city": "KNOB NOSTER",
            "state": "MO",
            "postal_code": "653361134",
            "telephone_number": "660-563-9800",
            "fax_number": "660-563-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANCEY",
        "first_name": "SYDNEE",
        "middle_name": "NICOLE",
        "credential": "DPT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-07",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2021034464",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2024023402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knob Noster, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.