Individual provider Active NPI

Mark A. Sanders, P.A.

  • Physician Assistant
  • Anderson, SC
National Provider Identifier
1316995483
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
470 Issued in SC
Practice address
800 N Fant St
Anderson, SC 29621-5708
Phone
(864) 512-1787
NPI assigned
May 4, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 470 SC Primary

Addresses

Primary practice location

800 N Fant St
Anderson, SC 29621-5708

Mailing address

800 N Fant St
Anderson, SC 29621-5708
Phone (864) 512-1417

Other identifiers 1

IdentifierTypeStateIssuer
0420PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20040204000686 SC Practitioner - Physician Assistant 1355234204 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
470SCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Pathology Associates PA Current Accepting new patients
Anmed Health CurrentSince Oct 21, 2006 Accepting new patients
Anmed Health CurrentSince Oct 21, 2006 Accepting new patients
Anmed Health Physician Assistant Current Accepting new patients
Diagnostic Radiology of Anderson, P.a. Current Accepting new patients
Self Regional Healthcare Past Accepting new patients

Locations

2000 E Greenville St
Anderson, SC 29621
Phone (864) 512-1000

800 N Fant St
Anderson, SC 29621
Phone (864) 512-1000

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1316995483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215708",
            "telephone_number": "864-512-1417",
            "fax_number": "864-512-1823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N FANT ST",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215708",
            "telephone_number": "864-512-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MARK",
        "middle_name": "A.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0420PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.