Active NPI
Guadalupe Sanchez, MD
- Dermatology Physician
- St Peters, MO
National Provider Identifier
1013919844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- R7D23
- Practice address
- 70 Jungermann Cir
Suite 203
St Peters, MO 63376-1622 - Phone
- (636) 447-5197
- Fax
- (636) 928-0994
- NPI assigned
- Aug 11, 2005
- Reactivated
- Aug 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | R7D23 | MO | Primary |
Addresses
Primary practice location
70 Jungermann Cir
Suite 203
St Peters, MO 63376-1622
Mailing address
70 Jungermann Cir
#203, Family Dermatology Center LC
St Peters, MO 63376-1622
Phone (636) 447-5197
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070001270 | Other | RAILROAD MEDICARE | |
| 180467 | Other | HEALTHLINK | |
| 7588 | Other | BLUE CROSS BLUE SHIELD | |
| 202216016 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R7D23 | MO | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440028800000",
"number": "1013919844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 JUNGERMANN CIR",
"address_2": "#203, FAMILY DERMATOLOGY CENTER LC",
"city": "ST PETERS",
"state": "MO",
"postal_code": "633761622",
"telephone_number": "636-447-5197",
"fax_number": "636-928-0994"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 JUNGERMANN CIR",
"address_2": "SUITE 203",
"city": "ST PETERS",
"state": "MO",
"postal_code": "633761622",
"telephone_number": "636-447-5197",
"fax_number": "636-928-0994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANCHEZ",
"first_name": "GUADALUPE",
"name_prefix": "Ms.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-08-11",
"last_updated": "2015-08-20",
"deactivation_date": "2014-12-16",
"reactivation_date": "2015-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MO",
"license": "R7D23",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "070001270",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "180467",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "7588",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202216016",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Peters, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.