Active NPI
Roldon Sanchez, PA
- Physician Assistant
- Ardmore, OK
National Provider Identifier
1073577748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA877
- Practice address
- 2002 12TH Ave NW
Suite B
Ardmore, OK 73401-1206 - Phone
- (580) 223-4795
- Fax
- (580) 223-5184
- NPI assigned
- Apr 12, 2006
- Last updated
- Jul 13, 2026
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA877 | OK | Primary |
Addresses
Primary practice location
2002 12TH Ave NW
Suite B
Ardmore, OK 73401-1206
Mailing address
1015 S Commerce St
Suite B
Ardmore, OK 73401-5018
Phone (580) 223-4795
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200067040A | Medicaid | OK | |
| 970010036 | Other | OK | RAILROAD MEDICARE |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 877 | OK | MD | Marriage & Family Therapist |
| PA877 | OK | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1073577748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 S COMMERCE ST",
"address_2": "SUITE B",
"city": "ARDMORE",
"state": "OK",
"postal_code": "734015018",
"telephone_number": "580-223-4795",
"fax_number": "580-223-5184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2002 12TH AVE NW",
"address_2": "SUITE B",
"city": "ARDMORE",
"state": "OK",
"postal_code": "734011206",
"telephone_number": "580-223-4795",
"fax_number": "580-223-5184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANCHEZ",
"first_name": "ROLDON",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "PA877",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200067040A",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "970010036",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ardmore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.