Stephanie Elizabeth Deruy, DPT
Individual provider Active NPI Physical Therapist · Overland Park, KS
NPI 1982916581 · NPPES record last updated May 22, 2014
Key facts
- NPI
- 1982916581
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11-04258 (KS)
- Practice address
- 11330 W 135TH St
Overland Park, KS 66221-8100 - Phone
- (913) 239-9539
- Fax
- (913) 239-9893
- NPI assigned
- Jul 12, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Select Physical Therapy Holdings Inc
Practice addresses (Care Compare)
100 E Kansas St
Suite C
Lansing, KS 66043-1610
Phone (913) 758-0283
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150306000946 | KS | Practitioner - Physical Therapist in Private Practice | 4385837962 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.017963 | IL | MD | Physical Therapist |
| 11-04258 | KS | MD | Physical Therapist |
| 2011026845 | MO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic Health of Kansas City P.C. | Current |
Accepting new patients | |
| Select Physical Therapy Holdings, Inc. | Physical Therapist | Current |
Accepting new patients |
| Athletic and Therapeutic Institute of Naperville, LLC | Physical Therapist | Past |
Accepting new patients |
Locations
100 E Kansas St
Ste C
Lansing, KS 66043
Phone (913) 758-0283
10900 W 86th St
Lenexa, KS 66214
Phone (816) 561-3003
1950 Diamond Pkwy
Ste 100
North Kansas City, MO 64116
Phone (816) 561-3003
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11-04258 | KS | Yes |
| Physical Therapist | 225100000X | 2011026845 | MO | |
| Physical Therapist | 225100000X | 070.017963 | IL |
Addresses
Primary practice location
11330 W 135TH St
Overland Park, KS 66221-8100
Mailing address
11330 W 135TH St
Overland Park, KS 66221-8100
Phone (913) 239-9539
Other names
- Stephanie Elizabeth Jones
Other providers in Overland Park, KS
- Derm Hair Center
- Dermatology Consultants Midwest P.a.
- Andrea Jett Dermyer
- Eric Deroo
- Megan Derosa
- Michaela Dervin
- Shannon N Desalvo
- Desire in Home Care Inc
- Parker Desjardins
- Ann Christine Deskin
All providers in Overland Park, KS · Physical Therapist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.