Mary Kae Sandidge, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP 1853212 Issued in FL

Practice address

4348 Southpoint Blvd Ste 100
Jacksonville, FL 32216-0903

Phone

(904) 281-1915

Fax

(904) 281-1119

NPI assigned

Nov 17, 2011

Last updated

Jan 17, 2019By 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

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

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.

• Iah of Florida, LLC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1750787982
  Medicare reassignment NPD
• Rmed LLC

  dba HarmonyCares Medical Group

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1508815358
  Medicare reassignment NPD
• Rmed LLC

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1205476793
  NPD

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

{
    "created_epoch": "1321488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1124395272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 NW 80TH PLACE",
            "city": "RAIFORD",
            "state": "FL",
            "postal_code": "32083",
            "telephone_number": "941-232-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4348 SOUTHPOINT BLVD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160903",
            "telephone_number": "904-281-1915",
            "fax_number": "904-281-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDIDGE",
        "first_name": "MARY",
        "middle_name": "KAE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-17",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 1853212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004575500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Riley Elizabeth Sanders
• Rosa Sanders
• Sarah Sanders
• Trevena Nicole Sanders, APRN
• Sukhwinder S Sandhu, M.D.
• Adam Jacob Sandin, DO
• Sandlake Living Assisted Home
• Sandlake Living Assisting Home
• E Dayan Sandler, MD
• Jeffrey M Sandler, M.D.

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.