Mary Jo Sanders, RN, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L3721 Issued in OR

Practice address

1651 Centennial Blvd
Springfield, OR 97477-3363

Phone

(541) 762-4551

NPI assigned

Jul 9, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: maryjo.sanders.p2@direct.lanecounty.nextgenshare.com

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1184887150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N 33RD ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974785838",
            "telephone_number": "541-746-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 CENTENNIAL BLVD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974773363",
            "telephone_number": "541-762-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MARY JO",
        "name_prefix": "Ms.",
        "credential": "RN, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3721",
            "primary": true
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "OR",
            "license": "000035076RN",
            "primary": false
        },
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "OR",
            "license": "00035076RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne Michelle Samar, M.D.
• Howard Russell Sampley Jr., M.D.
• Anahita Sanaie, M.D.
• James David Sanchez, MD
• Marissa Maryann Sanchez
• Alberto Sandoval
• Justin Basilio Rosales Sandoval
• Shalin R. Sanghvi, M.D.
• Ali Sangi, MD
• Toni Ann Santos, LPN

• All providers in Springfield, OR
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.