Active NPI
Sukhdeep Kaur Mander, NP
- Family Nurse Practitioner
- Spartanburg, SC
National Provider Identifier
1477091106
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 20460
- Practice address
- 322 N Pine St
Spartanburg, SC 29302-1631 - Phone
- (864) 431-1653
- Fax
- (864) 472-1850
- NPI assigned
- Feb 1, 2017
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 20460 | SC | Primary |
Addresses
Primary practice location
322 N Pine St
Spartanburg, SC 29302-1631
Mailing address
115 Data Bush Dr
Inman, SC 29349-9476
Phone (864) 431-1653
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170516000016 | SC | Practitioner - Nurse Practitioner | 7315224672 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
322 N Pine St
Spartanburg, SC 29302-1631
Phone (864) 582-5099
Hospital & facility affiliations
- Spartanburg Medical Center
- Pelham Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20460 | SC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nephrology Associates of Spartanburg, LLC | Current | Accepting new patients |
Locations
322 N Pine St
Spartanburg, SC 29302
Phone (864) 582-5099
Organizations & group practices 1
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.
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490572800000",
"number": "1477091106",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 DATA BUSH DR",
"city": "INMAN",
"state": "SC",
"postal_code": "293499476",
"telephone_number": "864-431-1653",
"fax_number": "864-472-1850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "322 N PINE ST",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293021631",
"telephone_number": "864-431-1653",
"fax_number": "864-472-1850"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDER",
"first_name": "SUKHDEEP",
"middle_name": "KAUR",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-02-01",
"last_updated": "2017-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "20460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spartanburg, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.