Active NPI
Terry Gay Sanders, PA-C
- Medical Physician Assistant
- Baton Rouge, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- A10174
- Practice address
- 5247 Didesse Dr
Baton Rouge, LA 70808-9153 - Phone
- (225) 765-3076
- Fax
- (225) 765-3090
- NPI assigned
- Jul 24, 2006
- Last updated
- Feb 10, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | A10174 | LA | Primary |
Addresses
Primary practice location
5247 Didesse Dr
Baton Rouge, LA 70808-9153
Mailing address
8300 Jo Lee Dr
Denham Springs, LA 70706-8539
Phone (225) 937-4086
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1009733 | Medicaid | LA | |
| P00408733 | Other | LA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A10174 | LA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Our Lady of the Lake Physician Group LLC | Current | Accepting new patients | |
| Our Lady of the Lake Physician Group, LLC | Current | Accepting new patients | |
| Our Lady of the Lake Hospital Inc | Past | Accepting new patients |
Locations
5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050
5247 Didesse Dr
Baton Rouge, LA 70808
Phone (225) 765-2273
8415 Goodwood Blvd
Ste 105
Baton Rouge, LA 70806
Phone (225) 765-4226
18989 Old Scenic Hwy
Zachary, LA 70791
Phone (225) 654-6140
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Baton Rouge, LA
- NPI 1033494943
-
dba Our Lady of the Lake Children's Health Developmental Center at McMains
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Baton Rouge, LA
- NPI 1235912502
-
- Urgent Care Clinic/Center
- Baton Rouge, LA
- NPI 1588062079
-
dba Lake Primary Care Physicians
- Internal Medicine Physician
- Baton Rouge, LA
- NPI 1275577603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581292800000",
"number": "1457373664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8300 JO LEE DR",
"city": "DENHAM SPRINGS",
"state": "LA",
"postal_code": "707068539",
"telephone_number": "225-937-4086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5247 DIDESSE DR",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708089153",
"telephone_number": "225-765-3076",
"fax_number": "225-765-3090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "TERRY",
"middle_name": "GAY",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-24",
"last_updated": "2020-02-10",
"certification_date": "2020-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "LA",
"license": "A10174",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1009733",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00408733",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.