NPIMap

Individual provider Active NPI

Corie Lynn Sandall, MD

  • Internal Medicine Physician
  • Bonney Lake, WA
National Provider Identifier
1013996180
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00045674 Issued in WA
Practice address
9230 Sky Island Dr E
Bonney Lake, WA 98391-7385
Phone
(253) 750-6000
Fax
(253) 750-6100
NPI assigned
Jan 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00045674 WA Primary

Addresses

Primary practice location

9230 Sky Island Dr E
Bonney Lake, WA 98391-7385

Mailing address

9230 Sky Island Dr E
Bonney Lake, WA 98391-7385
Phone (253) 750-6000

Other identifiers 1

IdentifierTypeStateIssuer
0210070OtherWASTATE L&I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060608000022 WA Practitioner - Internal Medicine 4284646316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Maryland School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

15214 Canyon Rd E
Puyallup, WA 98375-7472

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

Hospital & facility affiliations

  • Wesley Homes at Home, LLC Home health agency, Des Moines, WA, CCN 507092
  • Signature Healthcare at Home Home health agency, Federal Way, WA, CCN 507110
  • Centerwell Home Health Home health agency, Tacoma, WA, CCN 507031
  • Puget Sound Home Health Home health agency, Tacoma, WA, CCN 507101
  • CHI Franciscan Health at Home Home health agency, University Place, WA, CCN 507124
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141
  • St Elizabeth Hospital Hospital, Enumclaw, WA, CCN 501335
  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021
  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Internal Medicine CurrentSince Aug 31, 2006 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

9230 Sky Island Dr E
Stop 1201
Bonney Lake, WA 98391

9230 Sky Island Dr E
Bonney Lake, WA 98391
Phone (253) 750-6000

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: csandall6967@fhsce.catholichealth.net

Organizations & group practices 3

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407110400000",
    "number": "1013996180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9230 SKY ISLAND DR E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917385",
            "telephone_number": "253-750-6000",
            "fax_number": "253-750-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9230 SKY ISLAND DR E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917385",
            "telephone_number": "253-750-6000",
            "fax_number": "253-750-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDALL",
        "first_name": "CORIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2014-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00045674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0210070",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

Verify at the official NPI Registry.