Peatric Sambol-Gordon, RN,BSN,MBA,ACHA

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

1359686111 Issued in KS

Practice address

4646 Sortor Dr
Kansas City, KS 66104-1253

Phone

(913) 233-6247

NPI assigned

May 14, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Master of Business Administration, Registered Nurse

State licenses

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336953600000",
    "number": "1245599075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 SORTOR DR",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661041253",
            "telephone_number": "913-233-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 SORTOR DR",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661041253",
            "telephone_number": "913-233-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMBOL-GORDON",
        "first_name": "PEATRIC",
        "name_prefix": "Mrs.",
        "credential": "RN,BSN,MBA,ACHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-14",
        "last_updated": "2012-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "1359686111",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "122895",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "KS",
            "license": "3450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Salva
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• Atiyeh Samadi
• Ipsita Samanta
• Radmila Samardzija, DPM
• Farhan Ismael Sami, MD
• Tara Samiee, DO
• Sams West Inc (Sams Pharmacy 10-4870)
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• Rachel Sams, LMFT

• Registered Nurse in Kansas City, KS
• Providers in Kansas City, KS by specialty
• Registered Nurse in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; 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.