Individual provider Active NPI

Charles Tracy Sands Jr., D.C.

  • Chiropractor
  • Pompano Beach, FL
National Provider Identifier
1396789442
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH4637 Issued in FL
Practice address
1701 NE 28TH St
Pompano Beach, FL 33064-6859
Phone
(954) 942-8402
Fax
(954) 946-7540
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH4637 FL Primary

Addresses

Primary practice location

1701 NE 28TH St
Pompano Beach, FL 33064-6859

Mailing address

1701 NE 28TH St
Pompano Beach, FL 33064-6859
Phone (954) 942-8402

Other identifiers 1

IdentifierTypeStateIssuer
380444500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110927000247 FL Practitioner - Chiropractic 1658542469 Receives reassigned benefits from 1 practitioner
Practice locations: Pompano Beach, FL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1701 NE 28TH St
Pompano Beach, FL 33064-6859

1701 Ne28Th St
Pompano Beach, FL 33064-6859
Phone (954) 942-8402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kimberly Sands-Kahn DC Chiropractor PastSince Aug 29, 2011 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284336000000",
    "number": "1396789442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 NE 28TH ST",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330646859",
            "telephone_number": "954-942-8402",
            "fax_number": "954-946-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 NE 28TH ST",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330646859",
            "telephone_number": "954-942-8402",
            "fax_number": "954-946-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDS",
        "first_name": "CHARLES",
        "middle_name": "TRACY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2010-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH4637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380444500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; 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.

Verify at the official NPI Registry.