Individual provider Active NPI

Everette Theodore Sitzman Jr., MD

  • Psychiatry Physician
  • Prairie Village, KS
National Provider Identifier
1871572792
Registry record updated May 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
04 22079 Issued in KS
Practice address
5200 W 94TH Ter
Ste 105
Prairie Village, KS 66207-2522
Phone
(913) 649-5567
Fax
(913) 649-7563
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2010

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 04 22079 KS Primary
Geriatric Psychiatry Physician 2084P0805X 04 22079 KS

Addresses

Primary practice location

5200 W 94TH Ter
Ste 105
Prairie Village, KS 66207-2522

Mailing address

5200 W 94TH Ter
Ste 105
Prairie Village, KS 66207-2522
Phone (913) 649-5567

Other identifiers 1

IdentifierTypeStateIssuer
15094011OtherBC BS OF KC

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04 22079KSMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vellore Kirubakaran M D P a Psychiatry Past Accepting new patients
E Kent Stevenson MD PC Psychiatry Past Accepting new patients
Psychiatry Associates of Kansas City PA Psychiatry PastSince Apr 30, 2003 Accepting new patients
Psychpros of Kansas City PastSince Feb 4, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274745600000",
    "number": "1871572792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 W 94TH TER",
            "address_2": "STE 105",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662072522",
            "telephone_number": "913-649-5567",
            "fax_number": "913-649-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 W 94TH TER",
            "address_2": "STE 105",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662072522",
            "telephone_number": "913-649-5567",
            "fax_number": "913-649-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITZMAN",
        "first_name": "EVERETTE",
        "middle_name": "THEODORE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2010-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "04 22079",
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "KS",
            "license": "04 22079",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS OF KC",
            "identifier": "15094011",
            "state": null
        }
    ],
    "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 May 25, 2010; 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.