Individual provider Active NPI

Sonni P Elliott, M.D.

  • Psychiatry Physician
  • Leawood, KS
National Provider Identifier
1609066240
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
04-35752 Issued in KS
Practice address
12620 Juniper Cir
Leawood, KS 66209-3129
Phone
(314) 324-1202
NPI assigned
Jul 30, 2007
Last updated
May 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2010015932 MO
Psychiatry Physician 2084P0800X 04-35752 KS Primary

Addresses

Primary practice location

12620 Juniper Cir
Leawood, KS 66209-3129

Mailing address

PO Box 11532
Overland Park, KS 66207-4232
Phone (913) 333-0448

Other identifiers 1

IdentifierTypeStateIssuer
200655980BMedicaidKS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address selliott@mindfulstepskc.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121005000610 KS Practitioner - Psychiatry 5193859676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6900 College Blvd
Suite 740
Overland Park, KS 66211-1841
Phone (314) 324-1202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2010015932MOMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Psychiatry Inc Psychiatry CurrentSince Mar 21, 2022 Accepting new patients

Locations

6900 College Blvd
Ste 740
Overland Park, KS 66211
Phone (314) 324-1202

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, 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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1609066240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11532",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662074232",
            "telephone_number": "913-333-0448",
            "fax_number": "913-444-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12620 JUNIPER CIR",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662093129",
            "telephone_number": "314-324-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "SONNI",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "2010015932",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "04-35752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200655980B",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "selliott@mindfulstepskc.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12620 Juniper Cir",
            "city": "Leawood",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662093129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

Verify at the official NPI Registry.