Active NPI
Christina Jean Sanderson, AUDIOLOGIST
- Audiologist
- Columbia, MO
National Provider Identifier
1336379676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 2009015696
- Practice address
- 812 Keene St
Columbia, MO 65201-6633 - Phone
- (573) 817-3000
- Fax
- (573) 876-6950
- NPI assigned
- Jul 21, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 2009015696 | MO | Primary |
Addresses
Primary practice location
812 Keene St
Columbia, MO 65201-6633
Mailing address
PO Box 7687
Columbia, MO 65205-7687
Phone (573) 882-2259
Other names 1
- Christina Jean Clark
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2009015696 | MO | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294185600000",
"number": "1336379676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7687",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652057687",
"telephone_number": "573-882-2259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 KEENE ST",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652016633",
"telephone_number": "573-817-3000",
"fax_number": "573-876-6950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERSON",
"first_name": "CHRISTINA",
"middle_name": "JEAN",
"credential": "AUDIOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-21",
"last_updated": "2011-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MO",
"license": "2009015696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTINA",
"last_name": "CLARK",
"middle_name": "JEAN",
"credential": "AUDIOLOGIST",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.