Active NPI
Martin Luke Sanford, D.C.
- Chiropractor
- Portola, CA
National Provider Identifier
1386776367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 31697
- Practice address
- 15 Commercial St
Portola, CA 96122-9617 - Phone
- (530) 832-4442
- NPI assigned
- Mar 12, 2007
- Last updated
- Jan 21, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | B01037 | NV | |
| Chiropractor | 111N00000X | 31697 | CA | Primary |
Addresses
Primary practice location
15 Commercial St
Portola, CA 96122-9617
Mailing address
15 Commercial St
Portola, CA 96122-9617
Phone (530) 832-4442
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110407000789 | CA | Practitioner - Chiropractic | 4183652902 | Practice locations: Portola, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Western States College of Chiropractic, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
15 Commercial St
Portola, CA 96122-9617
Phone (530) 832-4442
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31697 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295568000000",
"number": "1386776367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 COMMERCIAL ST",
"city": "PORTOLA",
"state": "CA",
"postal_code": "961229617",
"telephone_number": "530-832-4442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 COMMERCIAL ST",
"city": "PORTOLA",
"state": "CA",
"postal_code": "961229617",
"telephone_number": "530-832-4442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANFORD",
"first_name": "MARTIN",
"middle_name": "LUKE",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-12",
"last_updated": "2011-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NV",
"license": "B01037",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "31697",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portola, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.