Individual provider Active NPI

Heather Rucker, DPT

  • Physical Therapy Clinic/Center
  • Overland Park, KS
National Provider Identifier
1437720869
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
11-06796 Issued in KS
Practice address
3795 W 95TH St
Overland Park, KS 66206-2036
Phone
(191) 328-6042
Fax
(844) 380-0832
NPI assigned
Jul 7, 2021
Last updated
Jul 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 11-06796 KS Primary

Addresses

Primary practice location

3795 W 95TH St
Overland Park, KS 66206-2036

Mailing address

3795 W 95TH St
Overland Park, KS 66206-2036
Phone (191) 328-6042

Other practice location 1

15044 S Blackbob Rd
Olathe, KS 66062-2663
Phone (913) 449-9696

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220328002269 KS Practitioner - Physical Therapist in Private Practice 1456746528 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SLPT LLCGroup PAC ID 1254764350, 6 clinicians

Practice addresses (Care Compare)

11036 Oakmont St
Overland Park, KS 66210-1100
Phone (913) 413-0012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-06796KSMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
SLPT, LLC CurrentSince Mar 21, 2022 Accepting new patients
LSCM, LLC Physical Therapy CurrentSince Mar 21, 2022 Accepting new patients
KC Developmental Therapies, LLC CurrentSince Jul 17, 2021 Accepting new patients

Locations

10600 Mastin St
#B
Overland Park, KS 66212
Phone (913) 269-3232

11036 Oakmont St
Overland Park, KS 66210
Phone (913) 413-0012

3795 W 95th St
Overland Park, KS 66206
Phone (913) 286-0422

15100 Metcalf Ave
Ste 102
Stanley, KS 66223
Phone (913) 681-0606

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1437720869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3795 W 95TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662062036",
            "telephone_number": "191-328-6042",
            "fax_number": "844-380-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3795 W 95TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662062036",
            "telephone_number": "191-328-6042",
            "fax_number": "844-380-0832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15044 S Blackbob Rd",
            "address_purpose": "LOCATION",
            "city": "Olathe",
            "state": "KS",
            "postal_code": "660622663",
            "country_code": "US",
            "telephone_number": "913-449-9696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "HEATHER",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "KS",
            "license": "11-06796",
            "primary": true
        }
    ],
    "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 7, 2021; 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.