Individual provider Active NPI

Sandra M Anderson, AU.D.CCC-A

  • Audiologist
  • High Point, NC
National Provider Identifier
1265453096
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
4855 Issued in NC
Practice address
624 Quaker LN
Suite 208C
High Point, NC 27262-3832
Phone
(336) 802-2085
Fax
(336) 802-2086
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Florida College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Otolaryngology Head and Neck Surgery Associates 16 clinicians

Practice addresses (Care Compare)

144 Concord Rd
Knoxville, TN 37934-2901
Phone (865) 777-1727

623 Congress Pkwy S
Athens, TN 37303-2259
Phone (865) 777-1727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230726003153 TN Practitioner - Qualified Audiologist 5698840130 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4855NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Otolaryngology Head and Neck Surgery Associates CurrentSince Jul 1, 2023 Accepting new patients
Cornerstone Health Care PA Past Accepting new patients
Merit Anesthesia PLLC PastSince Feb 17, 2020 Accepting new patients

Locations

144 Concord Rd
Knoxville, TN 37934

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 4855 NC Primary

Addresses

NPPES NPI Registry

Primary practice location

624 Quaker LN
Suite 208C
High Point, NC 27262-3832

Mailing address

1701 Westchester Dr
Ste 850
High Point, NC 27262-7254
Phone (336) 802-2400

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
3404192MedicaidNC
640003894OtherNCRR MEDICARE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 25, 2009.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245888000000",
    "number": "1265453096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WESTCHESTER DR",
            "address_2": "STE 850",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272627254",
            "telephone_number": "336-802-2400",
            "fax_number": "336-802-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 QUAKER LN",
            "address_2": "SUITE 208C",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272623832",
            "telephone_number": "336-802-2085",
            "fax_number": "336-802-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SANDRA",
        "middle_name": "M",
        "credential": "AU.D.CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2009-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "4855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404192",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "640003894",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.