Individual provider Active NPI

Judy C Sanders, ARNP/CNM

  • Family Nurse Practitioner
  • Tulsa, OK
National Provider Identifier
1003804956
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0093602 Issued in OK
Practice address
7901 S Sheridan Rd
Tulsa, OK 74133-8900
Phone
(918) 710-4112
Fax
(918) 710-4118
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0093602 OK Primary
Advanced Practice Midwife 367A00000X R0093602 OK

Addresses

Primary practice location

7901 S Sheridan Rd
Tulsa, OK 74133-8900

Mailing address

7901 S Sheridan Rd
Tulsa, OK 74133-8900
Phone (918) 710-4112

Other identifiers 2

IdentifierTypeStateIssuer
200222810AMedicaidOK
93602OtherSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180109001702 OK Order and Referring Only - Nurse Practitioner 0345334074

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Connection, Inc.Group PAC ID 5991756397, shared by 4 NPIs, 4 clinicians

Practice addresses (Care Compare)

9912 E 21St St
Tulsa, OK 74129-1620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0093602OKMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Health Stop LLC Past Accepting new patients
Community Health Connection Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1003804956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 S SHERIDAN RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741338900",
            "telephone_number": "918-710-4112",
            "fax_number": "918-710-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 S SHERIDAN RD",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741338900",
            "telephone_number": "918-710-4112",
            "fax_number": "918-710-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JUDY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "ARNP/CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0093602",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OK",
            "license": "R0093602",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200222810A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "93602",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.