Active NPI
Everette Theodore Sitzman Jr., MD
- Psychiatry Physician
- Prairie Village, KS
National Provider Identifier
1871572792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 04 22079
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15094011 | Other | BC 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
| License | State | Type | Specialty |
|---|---|---|---|
| 04 22079 | KS | MD | Geriatric Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New 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 | Past | Accepting new patients |
| Psychpros of Kansas City | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Psychiatry Physician
- Prairie Village, KS
- NPI 1275857575
-
- Psychiatry Physician
- Leawood, KS
- NPI 1356321947
-
- Psychiatry Physician
- Prairie Village, KS
- NPI 1669689188
-
- Mental Health Counselor
- Lees Summit, MO
- NPI 1629529888
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.