Active NPI
Renee Talanda Sandifer
- In Home Supportive Care Agency
- Portsmouth, VA
National Provider Identifier
1386956555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 1203
- Practice address
- 355 Crawford St
Portsmouth, VA 23704-2816 - Phone
- (757) 512-5734
- Fax
- (757) 942-8961
- NPI assigned
- Jul 5, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 1203 | VA | Primary |
Addresses
Primary practice location
355 Crawford St
Portsmouth, VA 23704-2816
Mailing address
1511 Basie Cres
Portsmouth, VA 23701-3931
Phone (757) 512-5734
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1203 | VA | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278288000000",
"number": "1386956555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1511 BASIE CRES",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237013931",
"telephone_number": "757-512-5734",
"fax_number": "757-942-8961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 CRAWFORD ST",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237042816",
"telephone_number": "757-512-5734",
"fax_number": "757-942-8961"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDIFER",
"first_name": "RENEE",
"middle_name": "TALANDA",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-05",
"last_updated": "2010-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "VA",
"license": "1203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.