Individual provider Active NPI

Christine Sanborn, CNP

  • Pediatric Nurse Practitioner
  • Wooster, OH
National Provider Identifier
1174705750
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN.CNP.10063 Issued in OH
Practice address
128 E Milltown Rd Ste 209
Wooster, OH 44691-1276
Phone
(330) 345-1100
Fax
(330) 345-1194
NPI assigned
Dec 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4704190607 MI
Pediatric Nurse Practitioner 363LP0200X APRN.CNP.10063 OH Primary

Addresses

Primary practice location

128 E Milltown Rd Ste 209
Wooster, OH 44691-1276

Mailing address

1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 345-1100

Other names 1

  • Christine Lee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20180213002661 OH Practitioner - Nurse Practitioner 4284875667 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704190607MIMDPediatric Nurse Practitioner
APRN.CNP.10063OHMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center of Akron CurrentSince Jan 6, 2018 Accepting new patients
Children'S Hospital Medical Center of Akron Current Accepting new patients
Children'S Hospital Medical Center of Akron CurrentSince Jan 6, 2018 Accepting new patients
Health Specialists of Lenawee, P.C. Past Accepting new patients
Dr. Shelly David Senders, MD, Inc PastSince Jul 15, 2021 Accepting new patients
Health Specialists of Lenawee P C Past Accepting new patients

Locations

1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050

128 E Milltown Rd
Ste 209
Wooster, OH 44691
Phone (330) 345-1100

Organizations & group practices 6

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": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1174705750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-345-1100",
            "fax_number": "330-345-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 E MILLTOWN RD STE 209",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446911276",
            "telephone_number": "330-345-1100",
            "fax_number": "330-345-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANBORN",
        "first_name": "CHRISTINE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704190607",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "APRN.CNP.10063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.