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Individual provider Active NPI

Sandra Y Suderman, ARNP

  • Family Nurse Practitioner
  • Bonner Springs, KS
National Provider Identifier
1679666077
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
44574 Issued in KS
Practice address
913 Sheidley Ave
Bonner Springs, KS 66012-9514
Phone
(913) 322-7222
Fax
(913) 322-7284
NPI assigned
Sep 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 44574 KS Primary

Addresses

Primary practice location

913 Sheidley Ave
Bonner Springs, KS 66012-9514

Mailing address

913 Sheidley Ave
Bonner Springs, KS 66012-9514
Phone (913) 322-7222

Other practice location 1

15604 Pinehurst Dr Ste 2
Basehor, KS 66007-8234
Phone (913) 728-2200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071105000130 KS Practitioner - Nurse Practitioner 8527155779 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Kansas School of Med (KC/Wich/Sal), 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

913 Sheidley Ave
Bonner Springs, KS 66012-9514
Phone (913) 322-7222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Physician Services - Providence Inc CurrentSince Apr 1, 2013 Accepting new patients
Prime Healthcare Physician Services - Providence Inc CurrentSince Apr 1, 2013 Accepting new patients
Providence Care Inc Past Accepting new patients
Living Water Family Care Past Accepting new patients
Amber Botros DO an Operating Division of Saint John Hospital Past Accepting new patients

Locations

15604 Pinehurst Dr
Ste 2
Basehor, KS 66007
Phone (913) 728-2200

15604 Pinehurst Dr
Basehor, KS 66007
Phone (913) 728-2200

913 Sheidley Ave
Bonner Springs, KS 66012
Phone (816) 301-4533

8929 Parallel Pkwy
Kansas City, KS 66112
Phone (913) 596-3930

757 W Eisenhower Rd
#R
Lansing, KS 66043
Phone (913) 297-2299

3550 S 4th St
Ste 282
Leavenworth, KS 66048
Phone (913) 318-7821

7315 E Frontage Rd
Ste 114
Merriam, KS 66204
Phone (913) 334-6500

1000 Carondelet Dr
Ofc
Kansas City, MO 64114
Phone (816) 943-7604

Organizations & group practices 5

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1679666077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 SHEIDLEY AVE",
            "city": "BONNER SPRINGS",
            "state": "KS",
            "postal_code": "660129514",
            "telephone_number": "913-322-7222",
            "fax_number": "913-322-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 SHEIDLEY AVE",
            "city": "BONNER SPRINGS",
            "state": "KS",
            "postal_code": "660129514",
            "telephone_number": "913-322-7222",
            "fax_number": "913-322-7284"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15604 Pinehurst Dr Ste 2",
            "address_purpose": "LOCATION",
            "city": "Basehor",
            "state": "KS",
            "postal_code": "660078234",
            "country_code": "US",
            "telephone_number": "913-728-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUDERMAN",
        "first_name": "SANDRA",
        "middle_name": "Y",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-30",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "44574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonner Springs, KS

Sources for this page

Verify at the official NPI Registry.