Individual provider Active NPI

Keia R Sanderson, MD

  • Pediatric Nephrology Physician
  • Chapel Hill, NC
National Provider Identifier
1093944407
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
2015-00912 Issued in NC
Practice address
7024 Burnett Womack
CB 7155
Chapel Hill, NC 27599-4619
Phone
(919) 445-6119
Fax
(919) 966-4251
NPI assigned
Jul 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 2015-00912 NC Primary

Addresses

Primary practice location

7024 Burnett Womack
CB 7155
Chapel Hill, NC 27599-4619

Mailing address

7024 Burnett Womack
CB 7155
Chapel Hill, NC 27599-4619
Phone (919) 445-6119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151008001832 NC Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Pediatric Medicine 0042528143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine, Pediatric Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of North Carolina at Chapel HillGroup PAC ID 0648181156, 2,028 clinicians

Practice addresses (Care Compare)

101 Manning Dr
Chapel Hill, NC 27514-4220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2015-00912NCMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Sep 1, 2015 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

2801 Blue Ridge Rd
Raleigh, NC 27607
Phone (984) 215-6435

Organizations & group practices 2

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": "1246924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1093944407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7024 BURNETT WOMACK",
            "address_2": "CB 7155",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275994619",
            "telephone_number": "919-445-6119",
            "fax_number": "919-966-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7024 BURNETT WOMACK",
            "address_2": "CB 7155",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275994619",
            "telephone_number": "919-445-6119",
            "fax_number": "919-966-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "KEIA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-07",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "NC",
            "license": "2015-00912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.