Stephanie Sanderson, NP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61006352 Issued in WA

Practice address

2005 W Main St Ste 110
Battle Ground, WA 98604-4311

Phone

(360) 882-2778

NPI assigned

Sep 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Stephanie Sidwell Former name

Medicare fee-for-service enrollment

Enrolled in WA, OR2 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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations (25 of 30)

Interoperability endpoints

• Direct secure messaging: stephanie.sanderson@211256354537476.direct.elationemr.com
• FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4
• Direct secure messaging: stephanie.sanderson.1@30646.direct.athenahealth.com

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.

• Peacehealth Networks on Demand, LLC

  dba Zoom Management

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178
  Medicare reassignment Care Compare group NPD
• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Everett, WA
  • NPI 1912235060
  Medicare reassignment NPD
• Providence Health & Services Washington

  dba Providence Medical Group SouthWest Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment NPD
• The Vancouver Clinic Inc PS

  dba The Vancouver Clinic

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1992759427
  Medicare reassignment NPD
• Maxem Health Urgent Care Lake Oswego

  • Urgent Care Clinic/Center
  • Lake Oswego, OR
  • NPI 1902478225
  Medicare reassignment NPD
• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1659897163
  NPD
• The Vancouver Clinic Inc PS

  dba Salmon Creek 2 Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Vancouver, WA
  • NPI 1306556907
  NPD
• The Vancouver Clinic Inc PS

  • Eyewear Supplier
  • Ridgefield, WA
  • NPI 1760004477
  NPD
• Zoomcare PC

  dba ZoomCare

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1689647372
  NPD (past)

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1205477361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4825",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084825",
            "telephone_number": "360-397-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 W MAIN ST STE 110",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986044311",
            "telephone_number": "360-882-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2005 W Main St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Battle Ground",
            "state": "WA",
            "postal_code": "986044311",
            "country_code": "US",
            "telephone_number": "360-882-2778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 SW Everett Mall Way Ste A",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982042715",
            "country_code": "US",
            "telephone_number": "888-562-5442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "STEPHANIE",
        "credential": "NP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-30",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "WA",
            "license": "AP61006352",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61006352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "SIDWELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tasha Marie Russell, LMP
• Margaret Rutledge
• Safeway Inc (Safeway Pharmacy #4313)
• Catarina Salazar
• Taylor Bryawn Samara
• Jean Marie Sangenito, BSN, RN
• Arti Tripathi Saraswat, MD, MPH
• Gudrun Schramm, LMP, LMT
• Mandy Leigh Scrivens, LDO
• Matthew Scrivens

• Family Nurse Practitioner in Battle Ground, WA
• Providers in Battle Ground, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.