Active NPI
Albert H Sanders, NP-C
- Family Nurse Practitioner
- Picayune, MS
National Provider Identifier
1447579495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R877250
- Practice address
- 2274 Highway 43 S
Picayune, MS 39466-8141 - Phone
- (601) 798-3989
- Fax
- (601) 798-3964
- NPI assigned
- May 28, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R877250 | MS | Primary |
Addresses
Primary practice location
2274 Highway 43 S
Picayune, MS 39466-8141
Mailing address
2274 Highway 43 S
Picayune, MS 39466-8141
Phone (601) 798-3989
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09372043 | Medicaid | MS | |
| 2130145 | Medicaid | LA | |
| 9260512 | Other | MS | AETNA |
| 12123429 | Other | MS | CAQH ID NUMBER |
| P00964914 | Other | MS | RAIL ROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- albert.sanders.3@1999.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392854400000",
"number": "1447579495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2274 HIGHWAY 43 S",
"city": "PICAYUNE",
"state": "MS",
"postal_code": "394668141",
"telephone_number": "601-798-3989",
"fax_number": "601-798-3964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2274 HIGHWAY 43 S",
"city": "PICAYUNE",
"state": "MS",
"postal_code": "394668141",
"telephone_number": "601-798-3989",
"fax_number": "601-798-3964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "ALBERT",
"middle_name": "H",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-28",
"last_updated": "2014-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R877250",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09372043",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2130145",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9260512",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH ID NUMBER",
"identifier": "12123429",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "P00964914",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Picayune, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.