Active NPI
Gabrielle K. Sauder, PNP
- Pediatric Nurse Practitioner
- Decatur, IL
National Provider Identifier
1073946141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 209.010763
- Practice address
- 2905 N Main St
Decatur, IL 62526-4274 - Phone
- (217) 877-9117
- Fax
- (217) 877-3082
- NPI assigned
- Aug 13, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 209.010763 | IL | Primary |
Addresses
Primary practice location
2905 N Main St
Decatur, IL 62526-4274
Mailing address
2905 N Main St
Decatur, IL 62526-4274
Phone (217) 877-9117
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.010763 | IL | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380240000000",
"number": "1073946141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2905 N MAIN ST",
"city": "DECATUR",
"state": "IL",
"postal_code": "625264274",
"telephone_number": "217-877-9117",
"fax_number": "217-877-3082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2905 N MAIN ST",
"city": "DECATUR",
"state": "IL",
"postal_code": "625264274",
"telephone_number": "217-877-9117",
"fax_number": "217-877-3082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAUDER",
"first_name": "GABRIELLE",
"middle_name": "K.",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-13",
"last_updated": "2013-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IL",
"license": "209.010763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.