Individual provider Active NPI

Abigail Sue June Sandridge, OTD

  • Occupational Therapist
  • Prairie Village, KS
National Provider Identifier
1497590178
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
2700 Somerset Dr
Prairie Village, KS 66206-1173
Phone
(913) 521-8851
NPI assigned
Jun 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

2700 Somerset Dr
Prairie Village, KS 66206-1173

Mailing address

10704 Countryside Dr
Kansas City, KS 66109-4734
Phone (660) 973-4519

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250306001245 KS Practitioner - Occupational Therapist in Private Practice 3375064355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Key Rehabilitation IncGroup PAC ID 9638086432, 59 clinicians

Practice addresses (Care Compare)

4200 S 4TH St
Leavenworth, KS 66048-5054
Phone (913) 758-6542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Key Rehabilitation, Inc CurrentSince Dec 26, 2024 Accepting new patients
Key Rehabilitation, Inc CurrentSince Dec 26, 2024 Accepting new patients

Locations

4200 S 4th St
Leavenworth, KS 66048
Phone (913) 682-7500

2020 N Tyler Rd
Wichita, KS 67212
Phone (316) 295-4591

1335 NW Broad St
Murfreesboro, TN 37129
Phone (615) 983-0240

Organizations & group practices 2

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": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1497590178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10704 COUNTRYSIDE DR",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661094734",
            "telephone_number": "660-973-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SOMERSET DR",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662061173",
            "telephone_number": "913-521-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDRIDGE",
        "first_name": "ABIGAIL",
        "middle_name": "SUE JUNE",
        "name_prefix": "Dr.",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prairie Village, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.