Individual provider Active NPI

Sandy Michele Branson, APRN

  • Nurse Practitioner
  • Fayetteville, AR
National Provider Identifier
1205030335
Registry record updated Nov 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
A02935 Issued in AR
Practice address
1970 E Joyce Blvd Ste 2
Fayetteville, AR 72703-5135
Phone
(479) 265-5198
Fax
(479) 339-3077
NPI assigned
Jun 13, 2007
Last updated
Nov 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X A02935 AR Primary
Registered Nurse 163W00000X R66717 AR

Addresses

Primary practice location

1970 E Joyce Blvd Ste 2
Fayetteville, AR 72703-5135

Mailing address

PO Box 12
Winslow, AR 72959-0012
Phone (479) 601-6201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20081014000077 AR Practitioner - Nurse Practitioner 1850469172 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R66717ARMDRegistered Nurse
A02935ARMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roller Weight Loss Institute,Inc. CurrentSince May 9, 2016 Accepting new patients
Roller Weight Loss Institute Inc CurrentSince May 9, 2016 Accepting new patients

Locations

1695 E Rainforest Rd
Fayetteville, AR 72703
Phone (479) 445-6460

Interoperability endpoints

  • Direct secure messaging: rollerweightlossandadvancedsurgery.sandybranson@118248.advancedmd-direct.com

Organizations & group practices 2

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764460800000",
    "number": "1205030335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "WINSLOW",
            "state": "AR",
            "postal_code": "729590012",
            "telephone_number": "479-601-6201",
            "fax_number": "479-339-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 E JOYCE BLVD STE 2",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035135",
            "telephone_number": "479-265-5198",
            "fax_number": "479-339-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANSON",
        "first_name": "SANDY",
        "middle_name": "MICHELE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2025-11-30",
        "certification_date": "2025-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A02935",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R66717",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.