Individual provider Active NPI

Susan Lee Sanders, DNP, FNP-C, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1093019952
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024184018 Issued in VA
Practice address
550 First Colonial Rd Ste 308-4651
Virginia Beach, VA 23451-6186
Phone
(765) 610-5006
Fax
(623) 666-6731
NPI assigned
Jan 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X PENDING AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 71003500A IN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024184018 VA Primary
Family Nurse Practitioner 363LF0000X 71003500A IN

Addresses

Primary practice location

550 First Colonial Rd Ste 308-4651
Virginia Beach, VA 23451-6186

Mailing address

8285 S Firefly Dr
Pendleton, IN 46064-9296
Phone (765) 610-5006

Other practice location 1

8285 S Firefly Dr
Pendleton, IN 46064-9296
Phone (765) 610-5006

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220409000406 VA Practitioner - Nurse Practitioner 1052594173 Practice locations: Norfolk, VA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3520 E Little Creek Rd
Suite D
Norfolk, VA 23518-3460
Phone (765) 610-5006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
PENDINGAZMDPhysician Assistant
71003500AINMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients

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": "1294272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1093019952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8285 S FIREFLY DR",
            "city": "PENDLETON",
            "state": "IN",
            "postal_code": "460649296",
            "telephone_number": "765-610-5006",
            "fax_number": "626-666-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 FIRST COLONIAL RD STE 308-4651",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234516186",
            "telephone_number": "765-610-5006",
            "fax_number": "623-666-6731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8285 S Firefly Dr",
            "address_purpose": "LOCATION",
            "city": "Pendleton",
            "state": "IN",
            "postal_code": "460649296",
            "country_code": "US",
            "telephone_number": "765-610-5006",
            "fax_number": "626-666-6731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "SUSAN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-C, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-06",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71003500A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024184018",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003500A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.