Individual provider Active NPI

John D Sanders, MD

  • Internal Medicine Physician
  • Charleston, SC
National Provider Identifier
1063470425
Registry record updated Sep 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7176 Issued in SC
Practice address
9275C Medical Plaza Dr
Ste C
Charleston, SC 29406
Phone
(843) 797-5667
Fax
(843) 569-2215
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2026

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 7176 SC Primary

Addresses

Primary practice location

9275C Medical Plaza Dr
Ste C
Charleston, SC 29406

Mailing address

9275C Medical Plaza Dr
Ste C
Charleston, SC 29406
Phone (843) 797-5667

Other identifiers 1

IdentifierTypeStateIssuer
071763MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040727000877 SC Practitioner - Internal Medicine 5890765069 Practice locations: Charleston, SC

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7176SCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789257600000",
    "number": "1063470425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9275C MEDICAL PLAZA DR",
            "address_2": "STE C",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29406",
            "telephone_number": "843-797-5667",
            "fax_number": "843-569-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9275C MEDICAL PLAZA DR",
            "address_2": "STE C",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29406",
            "telephone_number": "843-797-5667",
            "fax_number": "843-569-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JOHN",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2026-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "7176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071763",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.