Healthcare Provider Details

I. General information

NPI: 1396664967
Provider Name (Legal Business Name): SADIE HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 HUTTON RD STE 104
KANSAS CITY KS
66109-4566
US

IV. Provider business mailing address

1650 LYNDON FARM CT STE 300
LOUISVILLE KY
40223-5005
US

V. Phone/Fax

Practice location:
  • Phone: 913-725-8340
  • Fax: 913-228-1339
Mailing address:
  • Phone: 726-202-3039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number14-04197
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: