NPIMap

Organization Active NPI

Signature Medical Group of KC, P.a.

  • Orthopaedic Surgery Physician
  • Overland Park, KS
National Provider Identifier
1992087266
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SIGNATURE MEDICAL GROUP OF KC, P.A.
Practice address
10701 Nall Ave
Suite 200
Overland Park, KS 66211-1363
Phone
(913) 381-5225
Fax
(913) 901-0186
NPI assigned
Sep 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Authorized official

Name
Mr. Chad Sackman
Title
Ceo
Phone
(314) 849-0311

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X

Addresses

Primary practice location

10701 Nall Ave
Suite 200
Overland Park, KS 66211-1363

Mailing address

10701 Nall Ave Ste 200
Overland Park, KS 66211-1358
Phone (913) 381-5225

Other practice location 1

2737 NE McBaine Dr Ste A
Lees Summit, MO 64064-7880
Phone (913) 381-5225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120125000559 MO Part B Supplier - Clinic/Group Practice 7618144056 Receives reassigned benefits from 29 practitioners
Practice locations: Lees Summit, MO; Liberty, MO; Kansas City, MO; Independence, MO; Belton, MO
O20120215000695 KS Part B Supplier - Clinic/Group Practice 7618144056 Receives reassigned benefits from 28 practitioners
Practice locations: Shawnee Mission, KS; Overland Park, KS; Kansas City, KS; Olathe, KS; Leavenworth, KS

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

12140 Nall Ave
Ste 100
Overland Park, KS 66209
Phone (913) 451-8500

19550 E 39th St S
Ste 300
Independence, MO 64057
Phone (816) 478-0220

3151 NE Carnegie Dr
Lees Summit, MO 64064
Phone (816) 347-0026

2000 SE Blue Pkwy
Ste 165
Lees Summit, MO 64063
Phone (816) 282-5821

2529 Glenn Hendren Dr
Ste 200E
Liberty, MO 64068

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1992087266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 NALL AVE STE 200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111358",
            "telephone_number": "913-381-5225",
            "fax_number": "913-901-0186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 NALL AVE",
            "address_2": "SUITE 200",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111363",
            "telephone_number": "913-381-5225",
            "fax_number": "913-901-0186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2737 NE McBaine Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Lees Summit",
            "state": "MO",
            "postal_code": "640647880",
            "country_code": "US",
            "telephone_number": "913-381-5225",
            "fax_number": "913-901-0186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SIGNATURE MEDICAL GROUP OF KC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "SACKMAN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "314-849-0311",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.