NPIMap

Individual provider Active NPI

Kristofer Gibson Sandlund, MD

  • Family Medicine Physician
  • Zanesville, OH
National Provider Identifier
1407844749
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35048739S Issued in OH
Practice address
1215 Newark Road
Zanesville, OH 43701-2861
Phone
(740) 452-7359
Fax
(740) 452-7309
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35048739S OH Primary
General Practice Physician 208D00000X 35048739S OH

Addresses

Primary practice location

1215 Newark Road
Zanesville, OH 43701-2861

Mailing address

1215 Newark Road
Zanesville, OH 43701-2861
Phone (740) 452-7359

Other identifiers 1

IdentifierTypeStateIssuer
0549142MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20100722000008 OH Practitioner - Family Practice 4284655432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Group of Southeastern Ohio IncGroup PAC ID 8628232469, 61 clinicians

Practice addresses (Care Compare)

1215 Newark Rd
Zanesville, OH 43701-2620
Phone (740) 455-3304

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35048739SOHMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Zanesville Family Medical Center, Inc Family Medicine CurrentSince Dec 1, 2014 Accepting new patients
Zanesville Family Practice Inc Family Medicine CurrentSince Aug 1, 2001 Accepting new patients
Medical Home Primary Care Center Family Medicine Current Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Family Healthcare Partners PastSince May 1, 2018 Accepting new patients

Locations

1215 Newark Rd
Zanesville, OH 43701
Phone (740) 452-7359

3620 Court Dr
Ste K
Zanesville, OH 43701
Phone (740) 454-1248

200 N Maysville Ave
Zanesville, OH 43701
Phone (740) 455-3112

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kristofer.sandlund.p20@direct.pgseo.nextgenshare.com

Organizations & group practices 6

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1407844749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 NEWARK ROAD",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012861",
            "telephone_number": "740-452-7359",
            "fax_number": "740-452-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 NEWARK ROAD",
            "city": "ZANESVILLE",
            "state": "OH",
            "postal_code": "437012861",
            "telephone_number": "740-452-7359",
            "fax_number": "740-452-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDLUND",
        "first_name": "KRISTOFER",
        "middle_name": "GIBSON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35048739S",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "35048739S",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0549142",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zanesville, OH

Sources for this page

Verify at the official NPI Registry.