Sanford Dermatology

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

01072559A Issued in IN

Legal business name

SANFORD DERMATOLOGY

Doing business as

Hancock Dermatology

Practice address

400 W Green Meadows Dr Ste 110
Greenfield, IN 46140-3205

Phone

(317) 967-7921

Fax

(317) 967-7122

NPI assigned

Feb 15, 2016

Organization subpart

No

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

Authorized official

Name

Lori Sanford, M.D.NPI 1427282763

Title

Managing Member

Phone

(317) 460-1775

Specialties & licenses 1

Addresses

Other names 1

• Hancock Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lori Jacquemin Sanford, M.D.

  • Dermatology Physician
  • Greenfield, IN
  • NPI 1427282763
  Medicare reassignment Care Compare group NPD Authorized official
• Abigail Gregory, PA

  • Physician Assistant
  • Indianapolis, IN
  • NPI 1063880714
  Medicare reassignment Care Compare group
• Taylor P. Spera, PA

  • Physician Assistant
  • Noblesville, IN
  • NPI 1558734889
  Medicare reassignment Care Compare group
• Candice Wyatt, PA-C

  • Physician Assistant
  • Greenfield, IN
  • NPI 1619773744
  Medicare reassignment Care Compare group
• Benjamin Markus Farthing, DO, PHARMD

  • Dermatology Physician
  • Noblesville, IN
  • NPI 1194253898
  Medicare reassignment NPD
• Samantha Holmes Seward, MD

  • Dermatology Physician
  • Greenfield, IN
  • NPI 1497496418
  Medicare reassignment NPD
• Matthew Bradley Strausburg, M.D.

  • Dermatology Physician
  • Indianapolis, IN
  • NPI 1093057911
  Medicare reassignment NPD
• Gena M Gore, FNP-BC, DCNP

  • Family Nurse Practitioner
  • Indianapolis, IN
  • NPI 1376959692
  Medicare reassignment

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1447619747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W GREEN MEADOWS DR STE 110",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461403205",
            "telephone_number": "317-967-7921",
            "fax_number": "317-967-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W GREEN MEADOWS DR STE 110",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461403205",
            "telephone_number": "317-967-7921",
            "fax_number": "317-967-7122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "224 W Main St",
            "address_purpose": "LOCATION",
            "city": "Knightstown",
            "state": "IN",
            "postal_code": "461481260",
            "country_code": "US",
            "telephone_number": "317-967-7921",
            "fax_number": "317-967-7122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANFORD DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "SANFORD",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "317-460-1775",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IN",
            "license": "01072559A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hancock Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Payton Rutledge, RBT
• Kelly E Ryan, NP
• Payton Ryan
• Alexa V Salas Cheever
• Rachel A Sallee, PT,DPT
• Sanford Family Dentistry LLC
• Lori Jacquemin Sanford, M.D.
• Brett Steven Satkamp, MD
• Alyssa Ryan Schlachter, BCBA
• Kaillee Lynn Schnabel

• Medical Specialty Clinic/Center in Greenfield, IN
• Providers in Greenfield, IN by specialty
• Medical Specialty Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.