Individual provider Active NPI

Keasha Sanders, FNP-C

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1144658881
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP133451 Issued in TX
Practice address
1515 Holcombe Blvd
Houston, TX 77030
Phone
(713) 792-6161
NPI assigned
Oct 16, 2013
Last updated
May 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18013 TN
Family Nurse Practitioner 363LF0000X AP133451 TX Primary
Critical Care Medicine Registered Nurse 163WC0200X 166854 TN

Addresses

Primary practice location

1515 Holcombe Blvd
Houston, TX 77030

Mailing address

333 Commerce St Ste 700
Nashville, TN 37201-1835

Other practice location 1

2455 Dunstan Rd
Ste 360
Houston, TX 77005-2304
Phone (832) 786-4970

Other identifiers 2

IdentifierTypeStateIssuer
380171401MedicaidTX
380171402OtherTXMEDICAID CSHCN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, LA, NV, IN4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20171009002791 TX Practitioner - Nurse Practitioner 2365666740 Reassigns benefits to 2 organizations
I20240723003882 LA Practitioner - Nurse Practitioner 2365666740
I20241106001175 NV Practitioner - Nurse Practitioner 2365666740 Reassigns benefits to 1 organization
I20251108000581 IN Practitioner - Nurse Practitioner 2365666740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12900 Park Plaza Dr
Suite 150
Cerritos, CA 90703-9329

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166854TNMDCritical Care Medicine Registered Nurse
18013TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Referral Service CurrentSince Jun 17, 2017 Accepting new patients

Locations

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
#M
Houston, TX 77030
Phone (713) 792-2121

Interoperability endpoints

  • Direct secure messaging: ksanders21094@carelonhealth.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1144658881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 COMMERCE ST STE 700",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372011835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-792-6161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2455 Dunstan Rd",
            "address_2": "Ste 360",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770052304",
            "country_code": "US",
            "telephone_number": "832-786-4970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "KEASHA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-16",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18013",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133451",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TN",
            "license": "166854",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380171401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CSHCN",
            "identifier": "380171402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.