Individual provider Active NPI

Deanna L Sanders, FNP

  • Family Nurse Practitioner
  • Verona, MS
National Provider Identifier
1295004497
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R865623 Issued in MS
Practice address
5062 Raymond Ave
Verona, MS 38879
Phone
(662) 566-5593
Fax
(662) 566-4419
NPI assigned
Dec 19, 2011
Last updated
Dec 19, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R865623 MS Primary

Addresses

Primary practice location

5062 Raymond Ave
Verona, MS 38879

Mailing address

PO Box 429
Verona, MS 38879-0429
Phone (662) 566-5593

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20120312000493 MS Practitioner - Nurse Practitioner 2163681180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5062 Raymond Ave
Tupelo, MS 38801-8671
Phone (662) 566-5593

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R865623MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Clinics Inc Family Current Accepting new patients
North Mississippi Medical Clinics Inc CurrentSince Feb 1, 2015 Accepting new patients
John W. White, Jr., MD, PA Past Accepting new patients

Locations

1040A S Madison St
Tupelo, MS 38801
Phone (662) 842-2170

5062 Raymond Ave
Tupelo, MS 38801
Phone (662) 566-5593

845 S Madison St
Tupelo, MS 38801
Phone (601) 790-5025

Interoperability endpoints

  • Direct secure messaging: deannasanders@nmhs.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1295004497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 429",
            "city": "VERONA",
            "state": "MS",
            "postal_code": "388790429",
            "telephone_number": "662-566-5593",
            "fax_number": "662-566-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5062 RAYMOND AVE",
            "city": "VERONA",
            "state": "MS",
            "postal_code": "38879",
            "telephone_number": "662-566-5593",
            "fax_number": "662-566-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "DEANNA",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-19",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R865623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, MS

Sources for this page

Verify at the official NPI Registry.