Kelly Sandoval, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1168763 Issued in TX

Practice address

2901 W 7TH Ave
Corsicana, TX 75110-4811

Phone

(903) 616-0111

NPI assigned

Jul 26, 2024

Last updated

Jul 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DCS Medical PAGroup PAC ID 0042507600, 155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• DCS Medical PA

  dba Integrity Urgent Care

  • Urgent Care Clinic/Center
  • Princeton, TX
  • NPI 1285082768
  Medicare reassignment Care Compare group NPD
• DCS Medical PA

  dba Integrity Urgent Care

  • Rural Health Clinic/Center
  • Bonham, TX
  • NPI 1063138741
  NPD
• DCS Medical PA

  • Rural Health Clinic/Center
  • Athens, TX
  • NPI 1215671748
  NPD (past)

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1093544215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 W COLLIN ST",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751104239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 W 7TH AVE",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751104811",
            "telephone_number": "903-616-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "KELLY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1168763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rural Rehab Providers, LLC (Lott Physical Therapy)
• Jacquelyn Necole Rush
• S. and M.S. LLC (Arc Hospice & Palliative Care)
• Khalid Sadeddin, D.D.S
• Stephanie Sanderson
• Eneyine Ovezeyimi Sanni, PHARMD
• Joseph Edward Saucedo, DO
• Lori Michelle Saunders-Rodgers, MA CCC-SLP
• Thomas N Sawyerr, M.D.
• Cora Yvonne Schafer, PA

• Family Nurse Practitioner in Corsicana, TX
• Providers in Corsicana, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.