Debora Ivy Sanderson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP231074 Issued in ME

Practice address

1300 Enterprise Rd.
Socorro, NM 87801

Phone

(575) 835-4444

NPI assigned

Sep 26, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ME, OR2 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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthreach Community Health CentersGroup PAC ID 5496726523, shared by 12 NPIs, 87 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mainehealth Franklin Hospital Hospital, Farmington, ME, CCN 201316

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Northwest Medical Foundation of Tillamook

  • Critical Access Hospital
  • Tillamook, OR
  • NPI 1871575225
  Medicare reassignment NPD
• Rumford Community Family Health Center, Inc.

  • Rural Health Clinic/Center
  • Rumford, ME
  • NPI 1578599775
  Medicare reassignment NPD
• Rumford Hospital

  • Critical Access Hospital
  • Rumford, ME
  • NPI 1205991122
  Medicare reassignment NPD
• Healthreach Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Belgrade, ME
  • NPI 1851364632
  Medicare reassignment
• Northwest Medical Foundation of Tillamook

  • Critical Access Hospital
  • Sheridan, OR
  • NPI 1053873919
  NPD
• Rumford Community Family Health Center, Inc.

  • Rural Health Clinic/Center
  • Dixfield, ME
  • NPI 1902841083
  NPD
• Rumford Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Rumford, ME
  • NPI 1982742482
  NPD
• Healthreach Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Madison, ME
  • NPI 1184698441
  NPD (past)
• Healthreach Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Strong, ME
  • NPI 1417921776
  NPD (past)
• MH Health Care Services, PC

  • Nurse Practitioner
  • Cookeville, TN
  • NPI 1265749139
  NPD (past)
• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  NPD (past)

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

• Mainehealth

  • Critical Access Hospital
  • Farmington, ME
  • NPI 1922791417
  Care Compare affiliation

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1427044288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29212 US 127",
            "city": "PIKEVILLE",
            "state": "TN",
            "postal_code": "373674450",
            "telephone_number": "940-453-5788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 ENTERPRISE RD.",
            "city": "SOCORRO",
            "state": "NM",
            "postal_code": "87801",
            "telephone_number": "575-835-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY SANDERSON",
        "first_name": "DEBORA",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP114027",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ME",
            "license": "CNP231074",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "65006",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tana Hudson, LISW
• Mary Gailand Hunter, RPH
• Ift Ambulance LLC
• Katherine Jean Imislund-Clarke, LMHC
• Robert Irvin
• Paula Jo Jackson, RPH
• Tara K Jaramillo, SLP
• Lauren Catherine Johnson, RN
• Leslie S Johnson, MD
• Dale Kemper, RPH

• Family Nurse Practitioner in Socorro, NM
• Providers in Socorro, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.