Individual provider Active NPI

Charlene Amanda Sanders

  • Acute Care Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1417689324
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN3017999 Issued in KY
Practice address
401 E Chestnut St Unit 690
Louisville, KY 40202-5706
Phone
(502) 588-4710
Fax
(502) 588-4771
NPI assigned
Jun 29, 2022
Last updated
Nov 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN3017999 KY Primary

Addresses

Primary practice location

401 E Chestnut St Unit 690
Louisville, KY 40202-5706

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-4710

Other practice location 1

325 W Dixie Ave
Elizabethtown, KY 42701-1757
Phone (870) 275-0700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220803002068 KY Practitioner - Nurse Practitioner 4789066093 Reassigns benefits to 2 organizations
I20251223000908 PA Practitioner - Nurse Practitioner 4789066093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiology Consultants of Philadelphia PCGroup PAC ID 5294620746, 154 clinicians

Practice addresses (Care Compare)

125 Medical Campus Dr
Suite 101
Lansdale, PA 19446-7205
Phone (215) 361-5020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN3017999KYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Jul 1, 2022 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Oct 1, 2022 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
Cardiology Consultants of Philadelphia, P.C. CurrentSince Jan 1, 2026 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jul 1, 2022 Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

325 W Dixie Ave
Elizabethtown, KY 42701
Phone (870) 275-0700

401 E Chestnut St
Unit 690
Louisville, KY 40202
Phone (502) 588-4710

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

125 Medical Campus Dr
Ste 101
Lansdale, PA 19446
Phone (215) 361-5020

1703 S Broad St
Ste 300
Philadelphia, PA 19148
Phone (215) 462-7100

207 N Broad St
Fl 3
Philadelphia, PA 19107
Phone (215) 361-5020

Organizations & group practices 7

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

Hospital & facility affiliations 1

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762819200000",
    "number": "1417689324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-4710",
            "fax_number": "502-588-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E CHESTNUT ST UNIT 690",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402025706",
            "telephone_number": "502-588-4710",
            "fax_number": "502-588-4771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 W Dixie Ave",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427011757",
            "country_code": "US",
            "telephone_number": "870-275-0700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "CHARLENE",
        "middle_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "APRN3017999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.