Jenna Nicole Sanders, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

01073708A Issued in IN

Practice address

2051 Clevidence Blvd Ste C
Clarksville, IN 47129-2278

Phone

(812) 280-6623

Fax

(812) 280-6627

NPI assigned

Mar 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Jenna Nicole Gingerich Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsanders40385@direct.nortonhealthcare.org

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.

• Community Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1588614994

  IN, Pediatrics

  Medicare reassignment NPD
• Norton Children'S Medical Group, LLC

  • Psychiatry Physician
  • Louisville, KY
  • NPI 1457999096

  KY

  Medicare reassignment NPD
• Norton Childrens Medical Group, LLC

  • Pediatrics Physician
  • Louisville, KY
  • NPI 1326695255

  IN, Pediatrics

  Medicare reassignment NPD
• Community Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1881192409
  NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Critical Care Medicine Physician
  • Louisville, KY
  • NPI 1386281657

  Pediatrics

  NPD
• Norton Children'S Medical Group, LLC

  • Pediatric Radiology Physician
  • Louisville, KY
  • NPI 1659913812
  NPD
• Community Medical Associates, Inc.

  • Neurological Surgery Physician
  • Louisville, KY
  • NPI 1922288760

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1437458114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 CLEVIDENCE BLVD STE C",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471292278",
            "telephone_number": "812-280-6623",
            "fax_number": "812-280-6627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JENNA",
        "middle_name": "NICOLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-21",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "47001",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01073708A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201249990",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100212230",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K298210",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsanders40385@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "2051 Clevidence Blvd Ste C",
            "city": "Clarksville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471292278",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2051 Clevidence Blvd Ste C",
            "city": "Clarksville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "471292278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNA",
            "last_name": "GINGERICH",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Andres Salazar
• Sam'S Club Optical
• Sams East Inc
• Courtney Tieree Samuels, APRN
• Chelsee Sanders
• Janelle Sauer
• Alicia Sawyer
• Suzanna M Schaefer
• Payton Schilling
• Trevor Jordan Schrock, DPT

• Pediatrics Physician in Clarksville, IN
• Providers in Clarksville, IN by specialty
• Pediatrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.