Sean Macon Sandridge

Primary specialty

ContractorTaxonomy code 171W00000X

License

1260225 Issued in VA

Practice address

13114 Midlothian Tpke
Midlothian, VA 23113-4206

Phone

(804) 594-7020

Fax

(804) 594-7021

NPI assigned

Jun 12, 2013

Last updated

Jun 13, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Niche Solutions LLC

  dba abec electronics

  • Emergency Response System Companies
  • Midlothian, VA
  • NPI 1922449768
  NPD (past) Authorized official

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

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1245678192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13114 MIDLOTHIAN TPKE",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231134206",
            "telephone_number": "804-594-7020",
            "fax_number": "804-594-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13114 MIDLOTHIAN TPKE",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231134206",
            "telephone_number": "804-594-7020",
            "fax_number": "804-594-7021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDRIDGE",
        "first_name": "SEAN",
        "middle_name": "MACON",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "VA",
            "license": "1260225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SS1787",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sams East Inc (Sams Pharmacy 10-6354)
• Donald P Sanders, M.D.
• Edward Sanders
• Kulbir Sandhu, MD
• Sandra L Thompson & Associates, Inc (Life Advantage Support Services)
• Maria F Sangri Gil
• Michelle Lauren Santiago, DO
• Padmini Santosh, MD
• Shikha Sarebahi, M.D
• Sara I Sarraf, MD

• Contractor in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Contractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.