Individual provider Active NPI

Jay B Sandy, NP

  • Nurse Practitioner
  • Winchester, VA
National Provider Identifier
1215917414
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0017137339 Issued in VA
Practice address
1818 Amherst St
Winchester, VA 22601-2869
Phone
(540) 450-0072
Fax
(540) 450-0074
NPI assigned
Jan 23, 2006
Last updated
Feb 10, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0017137339 VA Primary

Addresses

Primary practice location

1818 Amherst St
Winchester, VA 22601-2869

Mailing address

1818 Amherst St
Winchester, VA 22601-2869
Phone (540) 450-0072

Other identifiers 3

IdentifierTypeStateIssuer
7102150000MedicaidWV
1215917414MedicaidVA
P00657233OtherVAMEDICARE RR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20150812009253 WV Order and Referring Only - Nurse Practitioner 2860567468

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick Health Hospital Inc Past Accepting new patients
Virginia Brain and Spine Center Inc Past Accepting new patients

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1215917414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012869",
            "telephone_number": "540-450-0072",
            "fax_number": "540-450-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 AMHERST ST",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012869",
            "telephone_number": "540-450-0072",
            "fax_number": "540-450-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDY",
        "first_name": "JAY",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0017137339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7102150000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215917414",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00657233",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.