Individual provider Active NPI

William Bennett Sanders IV

  • Family Nurse Practitioner
  • Piney Flats, TN
National Provider Identifier
1154155406
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
37294 Issued in TN
Practice address
6559 Wildlife Cir
Piney Flats, TN 37686-2947
Phone
(276) 623-6226
NPI assigned
Aug 29, 2024
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 37294 TN Primary
Emergency Registered Nurse 163WE0003X 245815 TN

Addresses

Primary practice location

6559 Wildlife Cir
Piney Flats, TN 37686-2947

Mailing address

6559 Wildlife Cir
Piney Flats, TN 37686-2947
Phone (276) 623-6226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250728002402 VA Practitioner - Nurse Practitioner 6800303579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Practice addresses (Care Compare)

600 W Ridge Rd
Wytheville, VA 24382-1044
Phone (276) 625-8820

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
245815TNMDEmergency Registered Nurse
37294TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Coverage, LLC CurrentSince Jul 15, 2025 Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

600 W Ridge Rd
Wytheville, VA 24382
Phone (276) 228-0200

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1154155406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6559 WILDLIFE CIR",
            "city": "PINEY FLATS",
            "state": "TN",
            "postal_code": "376862947",
            "telephone_number": "276-623-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6559 WILDLIFE CIR",
            "city": "PINEY FLATS",
            "state": "TN",
            "postal_code": "376862947",
            "telephone_number": "276-623-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "WILLIAM",
        "middle_name": "BENNETT",
        "name_suffix": "IV",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "37294",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "TN",
            "license": "245815",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piney Flats, TN

Sources for this page

Verify at the official NPI Registry.