Kenneth Neil Sansome, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD26778 Issued in OR

Practice address

930 NW Jones Ave
Albany, OR 97321-1314

Phone

(541) 926-3922

NPI assigned

Aug 21, 2006

Last updated

Dec 8, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Benton County

  dba Benton County Drug Court

  • Addiction (Substance Use Disorder) Counselor
  • Corvallis, OR
  • NPI 1467512335
  NPD (past)
• Benton County

  dba Benton County Health Services

  • Federally Qualified Health Center (FQHC)
  • Alsea, OR
  • NPI 1588046791
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1336254879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 NW JONES AVE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211314",
            "telephone_number": "541-926-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 NW JONES AVE",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973211314",
            "telephone_number": "541-926-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSOME",
        "first_name": "KENNETH",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD26778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260270900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080120567",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA MA",
            "identifier": "0509356",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samaritan Open MRI LLC (Samaritan Willamette Valley Open MRI)
• Sergio Alejandro Sanchez Carrasco
• Valeria Jailene Sanchez
• Trista Sanders, LPN
• Karen Loraine Sangiovanni, CADC II
• Shannun Kay Santana, CRM
• Santiam Gastroenterology PC
• Lacey Jo Sapaugh
• Sarah Soric Therapy LLC (Dynamic Self Recovery)
• Brenna Sardar, BCBA

• Family Medicine Physician in Albany, OR
• Providers in Albany, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.