NPIMap

Organization Active NPI

Sanders and Associates. LLC

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1225295447
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34002652A Issued in IN
Legal business name
SANDERS AND ASSOCIATES. LLC
Practice address
5555 N Tacoma Ave
Suite 204
Indianapolis, IN 46220-3512
Phone
(317) 257-7434
Fax
(317) 221-7733
NPI assigned
May 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Authorized official

Name
Dr. Charles W Sanders, PH.D.NPI 1548245889
Title
Single Member
Phone
(317) 479-2315

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 34002652A IN Primary

Addresses

Primary practice location

5555 N Tacoma Ave
Suite 204
Indianapolis, IN 46220-3512

Mailing address

5555 N Tacoma Ave
Suite 204
Indianapolis, IN 46220-3547
Phone (317) 257-7434

Other identifiers 1

IdentifierTypeStateIssuer
000000541815OtherINANTHEM PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080909000510 IN Part B Supplier - Clinic/Group Practice 6002982402 Receives reassigned benefits from 8 practitioners
Practice locations: Indianapolis, IN; Plainfield, IN

National Provider Directory

National Provider Directory

Locations

5555 N Tacoma Ave
Ste 204
Indianapolis, IN 46220
Phone (317) 257-7434

1331 Section St
Plainfield, IN 46168
Phone (317) 257-7434

1012 Stafford Rd
Plainfield, IN 46168
Phone (317) 257-7434

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1225295447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 N TACOMA AVE",
            "address_2": "SUITE 204",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203547",
            "telephone_number": "317-257-7434",
            "fax_number": "317-221-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 N TACOMA AVE",
            "address_2": "SUITE 204",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203512",
            "telephone_number": "317-257-7434",
            "fax_number": "317-221-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDERS AND ASSOCIATES. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "SINGLE MEMBER",
        "authorized_official_telephone_number": "317-479-2315",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34002652A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000541815",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.