Active NPI
Kim M Sanders, D.C.
- Chiropractor
- Jacksonville, FL
National Provider Identifier
1336152974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH8174
- Practice address
- 7545 Centurion Pkwy
Suite 205
Jacksonville, FL 32256-0579 - Phone
- (904) 744-4100
- Fax
- (904) 744-4210
- NPI assigned
- Aug 14, 2006
- Last updated
- Jan 26, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH8174 | FL | Primary |
Addresses
Primary practice location
7545 Centurion Pkwy
Suite 205
Jacksonville, FL 32256-0579
Mailing address
7545 Centurion Pkwy
Suite 205
Jacksonville, FL 32256-0579
Phone (904) 744-4100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110405000395 | FL | Practitioner - Chiropractic | 8820272560 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH8174 | FL | MD | Chiropractor |
Interoperability endpoints
- drkim@sc0075.direct.chirotouch.md
Organizations & group practices 1
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.
-
- Chiropractor
- Jacksonville, FL
- NPI 1083912489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296000000000",
"number": "1336152974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7545 CENTURION PKWY",
"address_2": "SUITE 205",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322560579",
"telephone_number": "904-744-4100",
"fax_number": "904-744-4210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7545 CENTURION PKWY",
"address_2": "SUITE 205",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322560579",
"telephone_number": "904-744-4100",
"fax_number": "904-744-4210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "KIM",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2011-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH8174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.