NPIMap

Individual provider Active NPI

John Clancy Sanford, PA

  • Physician Assistant
  • Urbana, OH
National Provider Identifier
1487256293
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
204 Patrick Ave
Urbana, OH 43078-2302
Phone
(937) 653-3445
NPI assigned
Nov 16, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

204 Patrick Ave
Urbana, OH 43078-2302

Mailing address

204 Patrick Ave
Urbana, OH 43078-2302
Phone (937) 653-3445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210115002426 OH Practitioner - Physician Assistant 3971916768 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Springfield Primary Care LLCGroup PAC ID 7315361359, 37 clinicians
Community Mercy Health PartnersGroup PAC ID 6002884582, 5 clinicians

Practice addresses (Care Compare)

211 Northparke Dr
Springfield, OH 45503-1117
Phone (937) 390-1700

900 Scioto St
Suite 4
Urbana, OH 43078-2251
Phone (937) 653-4666

Hospital & facility affiliations

  • Community Mercy Home Care, LLC Home health agency, Springfield, OH, CCN 367447
  • Springfield Regional Medical Center Hospital, Springfield, OH, CCN 360086
  • Mercy Health - West Hospital Hospital, Cincinnati, OH, CCN 360234
  • Mercy Health - Urbana Hospital Hospital, Urbana, OH, CCN 361312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Mercy Health Partners CurrentSince Feb 14, 2021 Accepting new patients
Community Mercy Health Partners CurrentSince Feb 14, 2021 Accepting new patients
Community Mercy Health Partners Past Accepting new patients

Locations

900 Scioto St
Ste 4
Urbana, OH 43078
Phone (937) 653-4666

900 Scioto St
Ste 1
Urbana, OH 43078
Phone (937) 653-4666

204 Patrick Ave
Urbana, OH 43078
Phone (937) 484-6157

Interoperability endpoints

  • Direct secure messaging: jsanford807174@direct.bsmhealth.org

Organizations & group practices 9

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": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1487256293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 PATRICK AVE",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "430782302",
            "telephone_number": "937-653-3445",
            "fax_number": "937-484-6181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 PATRICK AVE",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "430782302",
            "telephone_number": "937-653-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "JOHN",
        "middle_name": "CLANCY",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, OH

Sources for this page

Verify at the official NPI Registry.