Individual provider Active NPI

Mary Jane Sirna, PTA

  • Athletic Trainer
  • Overland Park, KS
National Provider Identifier
1679767255
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
115713 Issued in MO
Practice address
10300 W 103Rd St
Suite 300
Overland Park, KS 66214-2642
Phone
(913) 894-1910
NPI assigned
Aug 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 115713 MO Primary

Addresses

Primary practice location

10300 W 103Rd St
Suite 300
Overland Park, KS 66214-2642

Mailing address

5021 S Cedar Crest Ave
Independence, MO 64055-6934
Phone (816) 478-8443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
115713MOMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Physical Therapy CurrentSince Nov 10, 2024 Accepting new patients

Locations

1161 NE Rice Rd
Lees Summit, MO 64086
Phone (816) 402-2178

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1679767255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5021 S CEDAR CREST AVE",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556934",
            "telephone_number": "816-478-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 W 103RD ST",
            "address_2": "SUITE 300",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662142642",
            "telephone_number": "913-894-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRNA",
        "first_name": "MARY",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "115713",
            "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 Aug 28, 2007; 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.