Individual provider Active NPI

Steven John Sanderson, ARNP

  • Adult Health Nurse Practitioner
  • Palm City, FL
National Provider Identifier
1104143965
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP9261929 Issued in FL
Practice address
938 SW Martin Downs Blvd
Palm City, FL 34990-2816
Phone
(318) 488-8066
NPI assigned
May 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP9261929 FL Primary

Addresses

Primary practice location

938 SW Martin Downs Blvd
Palm City, FL 34990-2816

Mailing address

938 SW Martin Downs Blvd
Palm City, FL 34990-2816
Phone (318) 488-8066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110614000549 FL Practitioner - Nurse Practitioner 7810174182 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mobile Medical Associates, P.L. CurrentSince Oct 2, 2016 Accepting new patients

Locations

938 SW Martin Downs Blvd
Palm City, FL 34990
Phone (772) 221-7620

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": "1272844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1104143965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "938 SW MARTIN DOWNS BLVD",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902816",
            "telephone_number": "318-488-8066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "938 SW MARTIN DOWNS BLVD",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902816",
            "telephone_number": "318-488-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "STEVEN",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-03",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9261929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm City, FL

Sources for this page

Verify at the official NPI Registry.