Individual provider Active NPI

Emillia Marie Bratanov Sanders, PA-C

  • Family Medicine Physician
  • Nixa, MO
National Provider Identifier
1316747942
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2025009903 Issued in MO
Practice address
501 N Old Wilderness Rd
Nixa, MO 65714-9490
Phone
(417) 269-2227
NPI assigned
Mar 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 2025009903 MO Primary

Addresses

Primary practice location

501 N Old Wilderness Rd
Nixa, MO 65714-9490

Mailing address

1821 E Vincent Dr
Springfield, MO 65804-4313
Phone (417) 766-5483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20250415003668 MO Practitioner - Physician Assistant 7214452945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 5799787784, 240 clinicians

Practice addresses (Care Compare)

501 N Old Wilderness Rd
Coxhealth Nixa
Nixa, MO 65714-9490
Phone (417) 269-2227

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers Family Medicine CurrentSince May 27, 2025 Accepting new patients
Lester E Cox Medical Centers Family Medicine CurrentSince May 27, 2025 Accepting new patients
Lester E. Cox Medical Centers Past Accepting new patients

Locations

501 N Old Wilderness Rd
Nixa, MO 65714
Phone (417) 269-2150

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.

Hospital & facility affiliations 3

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": "1741824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1316747942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 E VINCENT DR",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044313",
            "telephone_number": "417-766-5483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N OLD WILDERNESS RD",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657149490",
            "telephone_number": "417-269-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "EMILLIA",
        "middle_name": "MARIE BRATANOV",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2025009903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nixa, MO

Sources for this page

Verify at the official NPI Registry.