Individual provider Active NPI

Janel R Sanford, LMSW, LMAC

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1083017099
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
05654 Issued in KS
Practice address
300 W Douglas Ave Ste 205
Wichita, KS 67202-2904
Phone
(316) 759-9136
Fax
(316) 500-7862
NPI assigned
Oct 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 8527 KS
Clinical Social Worker 1041C0700X 05654 KS Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 150 KS

Addresses

Primary practice location

300 W Douglas Ave Ste 205
Wichita, KS 67202-2904

Mailing address

300 W Douglas Ave Ste 205
Wichita, KS 67202-2904
Phone (316) 759-9136

Other identifiers 3

IdentifierTypeStateIssuer
201125860AMedicaidKS
13564020OtherKSCAQH
3004627850001MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220202000821 KS Practitioner - Clinical Social Worker 4981092806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 W Douglas Ave
Suite 205
Wichita, KS 67202-2904
Phone (316) 759-9136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8527KSMDSocial Worker
05654KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Scrappy Enterprises, Inc CurrentSince Jan 1, 2022 Accepting new patients

Locations

300 W Douglas Ave
Ste 205
Wichita, KS 67202
Phone (316) 640-4261

Organizations & group practices 1

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": "1412380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1083017099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W DOUGLAS AVE STE 205",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672022904",
            "telephone_number": "316-759-9136",
            "fax_number": "316-500-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W DOUGLAS AVE STE 205",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672022904",
            "telephone_number": "316-759-9136",
            "fax_number": "316-500-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "JANEL",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LMSW, LMAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-04",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "8527",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "05654",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "150",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201125860A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13564020",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3004627850001",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.