Individual provider Active NPI

Scott T. Sander, O.D.

  • Corneal and Contact Management Optometrist
  • Lees Summit, MO
National Provider Identifier
1982795480
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
T03097 Issued in MO
Practice address
1850 NW Chipman Rd
Lees Summit, MO 64081-3938
Phone
(816) 524-3369
Fax
(816) 524-3415
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X T03097 MO Primary
Corneal and Contact Management Optometrist 152WC0802X KS1343-3 KS

Addresses

Primary practice location

1850 NW Chipman Rd
Lees Summit, MO 64081-3938

Mailing address

12904 Larsen St
Overland Park, KS 66213-3467
Phone (913) 851-7886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170627002110 KS Practitioner - Optometry 2769751221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
KS1343-3KSMDCorneal and Contact Management Optometrist
T03097MOMDCorneal and Contact Management Optometrist

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982795480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12904 LARSEN ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662133467",
            "telephone_number": "913-851-7886",
            "fax_number": "816-524-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 NW CHIPMAN RD",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640813938",
            "telephone_number": "816-524-3369",
            "fax_number": "816-524-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDER",
        "first_name": "SCOTT",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MO",
            "license": "T03097",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "KS",
            "license": "KS1343-3",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lees Summit, MO

Sources for this page

Verify at the official NPI Registry.