Jeremy Bernard Sanders, APRN, PMHNP-BC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

AP09799 Issued in LA

Practice address

314 W Hale St
Lake Charles, LA 70601

Phone

(337) 660-8918

Fax

(337) 433-3013

NPI assigned

Jan 23, 2018

Last updated

Oct 29, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Diabetes & Obesity Control LLC

  • General Practice Physician
  • Longville, LA
  • NPI 1841642717

  Single Specialty

  NPD (past)
• Michele Vincent, LCSW, LLC

  • Clinical Social Worker
  • New Iberia, LA
  • NPI 1851705156

  Single Specialty

  NPD (past)
• Priority Psychiatric Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Broussard, LA
  • NPI 1235451568

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1093213217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 LAKE ST # 6781",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706056500",
            "telephone_number": "337-660-8918",
            "fax_number": "337-433-3013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 W HALE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70601",
            "telephone_number": "337-660-8918",
            "fax_number": "337-433-3013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 Albertson Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Broussard",
            "state": "LA",
            "postal_code": "70518",
            "country_code": "US",
            "telephone_number": "337-330-4730",
            "fax_number": "337-330-4732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "805 Albertson Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Broussard",
            "state": "LA",
            "postal_code": "70518",
            "country_code": "US",
            "telephone_number": "337-330-4730",
            "fax_number": "337-330-4732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JEREMY",
        "middle_name": "BERNARD",
        "credential": "APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-23",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0005X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurodevelopmental Disabilities",
            "state": "LA",
            "license": "AP09799",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "RN128743",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "AP09799",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "LA",
            "license": "AP09799",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "LA",
            "license": "AP09799",
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "LA",
            "license": "AP09799",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samson Behavioral Services
• Ricardo Samudia, MD
• Elicia Sanders
• Eric A Sanders, DDS
• Gwendolyn Sanders
• Sandra D.M. Bruno, M.D., LLC (Moss Bluff Medical Clinic)
• Holly Elizabeth Sann, LPN
• Rijo Santhosh, RPH
• Jamal Ghazi Saqer, MD
• Stacey Sargent

• Psychiatry Physician in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Psychiatry Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.