Mary Deboest

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11-05780 Issued in KS

Practice address

6600 College Blvd Ste 130
Overland Park, KS 66211-1610

Phone

(816) 525-2840

Fax

(816) 525-2841

NPI assigned

Jun 11, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Suellentrop Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• BSP Kansas LLC

  dba Boost Physical Therapy and Sports Performance

  • Physical Therapy Clinic/Center
  • Overland Park, KS
  • NPI 1487903951

  Physical Therapist

  NPD

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1780065177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 COLLEGE BLVD",
            "address_2": "STE 130",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111610",
            "telephone_number": "816-525-2840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 COLLEGE BLVD STE 130",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111610",
            "telephone_number": "816-525-2840",
            "fax_number": "816-525-2841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2861 NE Independence Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640642379",
            "country_code": "US",
            "telephone_number": "816-525-2840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBOEST",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-11",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-05780",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2015016732",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "SUELLENTROP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deanna Sack, LLC
• Valerie Anne Deardorff, MD
• Elizabeth Patrice Debauge-Katzer, CRNA
• Danielle Kathryn Debbrecht, MS, PT
• Deboer Capital LLC
• John Richard Decarlis, LCSW-C
• Linda D. Decarlo, ARNP
• Decker Integrated Orthotics and Prosthetics, LLC
• Decourcy Chiropractic Clinic PA
• Martin St John Decourcy, DC

• Physical Therapist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Physical Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.