Individual provider Active NPI

Amanda Sharon Sanders, FNP-BC

  • Family Nurse Practitioner
  • Arlington, TN
National Provider Identifier
1053963736
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26240 Issued in TN
Practice address
5847 Airline Rd Ste 105
Arlington, TN 38002-1215
Phone
(901) 633-8463
Fax
(901) 504-1911
NPI assigned
Jul 12, 2019
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26240 TN Primary

Addresses

Primary practice location

5847 Airline Rd Ste 105
Arlington, TN 38002-1215

Mailing address

5847 Airline Rd Ste 105
Arlington, TN 38002-1215
Phone (901) 633-8463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20221026001564 TN Practitioner - Nurse Practitioner 3577939925 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Oct 5, 2022 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Oct 5, 2022 Accepting new patients
Bodyworx Health and Wellness LLC Family CurrentSince Nov 21, 2021 Accepting new patients

Locations

5847 Airline Rd
Ste 105
Arlington, TN 38002
Phone (901) 628-8464

8118 US Hwy 51 N
Millington, TN 38053

8118 US Hwy 51 N
Millington, TN 38053
Phone (901) 614-4455

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1562889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1053963736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5847 AIRLINE RD STE 105",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "380021215",
            "telephone_number": "901-633-8463",
            "fax_number": "901-504-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5847 AIRLINE RD STE 105",
            "city": "ARLINGTON",
            "state": "TN",
            "postal_code": "380021215",
            "telephone_number": "901-633-8463",
            "fax_number": "901-504-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "AMANDA",
        "middle_name": "SHARON",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-12",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TN

Sources for this page

Verify at the official NPI Registry.