NPIMap

Individual provider Active NPI

Mitchell Adam Sanford

  • Family Medicine Physician
  • Gulfport, MS
National Provider Identifier
1346726098
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
29354 Issued in MS
Practice address
12057 Highway 49 Ste C
Gulfport, MS 39503-3177
Phone
(228) 832-9385
Fax
(888) 498-3529
NPI assigned
Jul 16, 2018
Last updated
Mar 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 29354 MS Primary

Addresses

Primary practice location

12057 Highway 49 Ste C
Gulfport, MS 39503-3177

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (305) 500-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mitchell.sanford.1@29601.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211213002807 MS Practitioner - Family Practice 7719302975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12057 Hwy 49
Suite C
Gulfport, MS 39503-3177
Phone (228) 832-9385

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
6750OKMDGeneral Practice Dentistry
29354MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care Ms PC Family Medicine CurrentSince Apr 3, 2023 Accepting new patients
Centerwell Senior Primary Care Ms PC Family Medicine CurrentSince Apr 3, 2023 Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

12057 Highway 49
Ste C
Gulfport, MS 39503
Phone (228) 831-1140

Interoperability endpoints

  • Direct secure messaging: mitchell.sanford@centerwell.eclinicaldirectplus.com

Organizations & group practices 2

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.

Hospital & facility affiliations 62

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1346726098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "305-500-2000",
            "fax_number": "786-522-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12057 HIGHWAY 49 STE C",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033177",
            "telephone_number": "228-832-9385",
            "fax_number": "888-498-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "MITCHELL",
        "middle_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "29354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mitchell.sanford.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12057 Highway 49 Ste C",
            "city": "Gulfport",
            "state": "MS",
            "country_code": "US",
            "postal_code": "395033177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.