Individual provider Active NPI

Lauren Lee Sandefur, M.D.

  • Pediatrics Physician
  • Reno, NV
National Provider Identifier
1073872867
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
17521 Issued in NV
Practice address
901 E 2ND St Ste 201
Reno, NV 89502-1186
Phone
(775) 982-5000
Fax
(775) 982-3971
NPI assigned
May 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X PG168320 OR
Pediatrics Physician 208000000X 17521 NV Primary

Addresses

Primary practice location

901 E 2ND St Ste 201
Reno, NV 89502-1186

Mailing address

850 Harvard Way
Reno, NV 89502-2055
Phone (775) 982-5262

Other names 1

  • Lauren Lee Betty Harris Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20180213001512 NV Practitioner - Pediatric Medicine 9931354503 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PG168320ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Services LLC CurrentSince Feb 5, 2018 Accepting new patients
Community Care Services LLC CurrentSince Feb 5, 2018 Accepting new patients
Community Care Services LLC Current Accepting new patients
Community Care Services LLC Past Accepting new patients
Renown Regional Medical Center Past Accepting new patients
Community Care Services LLC Pediatrics Past Accepting new patients

Locations

901 E 2nd St
Ste 201
Reno, NV 89502
Phone (775) 843-2201

10315 Professional Cir
Reno, NV 89521
Phone (775) 982-5860

975 Ryland St
Ste 100
Reno, NV 89502
Phone (775) 982-5210

850 Harvard Way
Reno, NV 89502

Interoperability endpoints

  • Direct secure messaging: lsandefur125307@direct.renown.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515369600000",
    "number": "1073872867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 HARVARD WAY",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895022055",
            "telephone_number": "775-982-5262",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E 2ND ST STE 201",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021186",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDEFUR",
        "first_name": "LAUREN",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-14",
        "last_updated": "2018-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "PG168320",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "17521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "HARRIS",
            "middle_name": "LEE BETTY",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.