Active NPI
Jessica Marie Sanford, FNP
- Family Medicine Physician
- Dallas, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A170959
- Practice address
- 4055 Valley View LN
Dallas, TX 75244-5074 - Phone
- (855) 984-5121
- NPI assigned
- Sep 8, 2022
- Last updated
- Oct 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A170959 | IA | |
| Family Medicine Physician | 207Q00000X | A170959 | IA | Primary |
| General Practice Physician | 208D00000X | A170959 | IA |
Addresses
Primary practice location
4055 Valley View LN
Dallas, TX 75244-5074
Mailing address
63 SE Dorr Dr Apt Suite
Pleasant Hill, IA 50327-8564
Phone (515) 554-4787
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
8131 University Blvd
Clive, IA 50325-1123
Phone (515) 965-3405
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A170959 | IA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soderstrom Dermatology Center S C | Current | Accepting new patients | |
| Soderstrom Dermatology Center S C | Current | Accepting new patients | |
| Signify Health Medical Associates, PLLC | General Practice | Current | Accepting new patients |
| Fawad S. Zafar MD PC | Past | Accepting new patients |
Locations
1800 E 54th St
Ste B
Davenport, IA 52807
Phone (563) 242-3571
400 E Court Ave
Ste 110
Des Moines, IA 50309
8131 University Blvd
Des Moines, IA 50325
Phone (515) 225-8180
4909 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 674-7546
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Organizations & group practices 4
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.
-
dba Peoria Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- Peoria, IL
- NPI 1053362343
-
dba Lakeview Center for Urology
- Urology Physician
- West Des Moines, IA
- NPI 1649223835
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba MercyOne West Des Moines Medical Center
- General Acute Care Hospital
- West Des Moines, IA
- NPI 1538395975
-
dba MercyOne Des Moines Laboratory
- Clinical Medical Laboratory
- Des Moines, IA
- NPI 1104982743
Hospital
-
dba MercyOne Des Moines Medical Center
- General Acute Care Hospital
- Des Moines, IA
- NPI 1508964883
-
dba Mercy Medical Mammography Center
- Mammography Clinic/Center
- Des Moines, IA
- NPI 1477984367
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666137600000",
"number": "1295456184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "63 SE DORR DR APT SUITE",
"city": "PLEASANT HILL",
"state": "IA",
"postal_code": "503278564",
"telephone_number": "515-554-4787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4055 VALLEY VIEW LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752445074",
"telephone_number": "855-984-5121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANFORD",
"first_name": "JESSICA",
"middle_name": "MARIE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-08",
"last_updated": "2022-10-19",
"certification_date": "2022-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A170959",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "A170959",
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "IA",
"license": "A170959",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.