Individual provider Active NPI

Mark William Sankey, M.D.

  • Diagnostic Radiology Physician
  • Langley Afb, VA
National Provider Identifier
1265422240
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
44065 Issued in CO
Practice address
77 Nealy Ave
Langley Afb, VA 23665-2040
Phone
(757) 764-8290
NPI assigned
Oct 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 44065 CO Primary

Addresses

Primary practice location

77 Nealy Ave
Langley Afb, VA 23665-2040

Mailing address

77 Nealy Ave
Langley Afb, VA 23665-2040
Phone (757) 764-8290

Other identifiers 1

IdentifierTypeStateIssuer
69950856MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111222000239 FL Practitioner - Diagnostic Radiology 6800801259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Walton Rural Hospital LLCGroup PAC ID 8123559168, 29 clinicians

Practice addresses (Care Compare)

4413 US Hwy 331 S
Defuniak Springs, FL 32435-6307
Phone (850) 920-2065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
44065COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Walton Rural Hospital, LLC CurrentSince Feb 1, 2025 Accepting new patients
Diversified Radiology of Colorado, Inc Diagnostic Radiology Past Accepting new patients

Locations

4413 US Highway 331 S
Defuniak Springs, FL 32435
Phone (850) 892-5171

Networks

  • Optimum HealthCare HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325030400000",
    "number": "1265422240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 NEALY AVE",
            "city": "LANGLEY AFB",
            "state": "VA",
            "postal_code": "236652040",
            "telephone_number": "757-764-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 NEALY AVE",
            "city": "LANGLEY AFB",
            "state": "VA",
            "postal_code": "236652040",
            "telephone_number": "757-764-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANKEY",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2011-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "44065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "69950856",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Langley Afb, VA

Sources for this page

Verify at the official NPI Registry.