Individual provider Active NPI

Kathy E Sanford, PA-C

  • Physician Assistant
  • Sugar Land, TX
National Provider Identifier
1356326037
Registry record updated Dec 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04365 Issued in TX
Practice address
4690 Sweetwater Blvd
Suite 200
Sugar Land, TX 77479-3478
Phone
(281) 565-0033
Fax
(281) 565-0568
NPI assigned
Dec 14, 2005
Last updated
Dec 1, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2011

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 PA04365 TX Primary

Addresses

Primary practice location

4690 Sweetwater Blvd
Suite 200
Sugar Land, TX 77479-3478

Mailing address

4690 Sweetwater Blvd
Suite 200
Sugar Land, TX 77479-3478
Phone (281) 565-0033

Other identifiers 2

IdentifierTypeStateIssuer
194604801MedicaidTX
P00229305OtherTXMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322697600000",
    "number": "1356326037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4690 SWEETWATER BLVD",
            "address_2": "SUITE 200",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793478",
            "telephone_number": "281-565-0033",
            "fax_number": "281-565-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4690 SWEETWATER BLVD",
            "address_2": "SUITE 200",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774793478",
            "telephone_number": "281-565-0033",
            "fax_number": "281-565-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "KATHY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2011-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194604801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00229305",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.