Active NPI
John R Sanborn, MD
- Gynecology Physician
- Birmingham, MI
National Provider Identifier
1003897323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 4301039821
- Practice address
- 35046 Woodward Ave
Suite 100
Birmingham, MI 48009-0932 - Phone
- (248) 647-9860
- Fax
- (248) 647-9864
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 4301039821 | MI | Primary |
Addresses
Primary practice location
35046 Woodward Ave
Suite 100
Birmingham, MI 48009-0932
Mailing address
35046 Woodward Ave
Suite 100
Birmingham, MI 48009-0932
Phone (248) 647-9860
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2013 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301039821 | MI | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Directors Consultants PLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Bloomfield Hills, MI
- NPI 1245121177
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248220800000",
"number": "1003897323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35046 WOODWARD AVE",
"address_2": "SUITE 100",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480090932",
"telephone_number": "248-647-9860",
"fax_number": "248-647-9864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35046 WOODWARD AVE",
"address_2": "SUITE 100",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480090932",
"telephone_number": "248-647-9860",
"fax_number": "248-647-9864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANBORN",
"first_name": "JOHN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-14",
"last_updated": "2009-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "MI",
"license": "4301039821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.