Active NPI
Olga Sanford, MD
- Psychiatry Physician
- Clermont, FL
National Provider Identifier
1508031543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME 123463
- Practice address
- 3200 Citrus Tower Blvd
Clermont, FL 34711-7012 - Phone
- (352) 536-8200
- NPI assigned
- Apr 29, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 6914 | KS | |
| Psychiatry Physician | 2084P0800X | 0435265 | KS | |
| Psychiatry Physician | 2084P0800X | ME 123463 | FL | Primary |
Addresses
Primary practice location
3200 Citrus Tower Blvd
Clermont, FL 34711-7012
Mailing address
3200 Citrus Tower Blvd
Clermont, FL 34711-7012
Phone (352) 536-8200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1K132Z | Other | FL | MEDICARE PTAN |
Other names 1
- Olga Sanford Kereches
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 123463 | FL | MD | Psychiatry Physician |
| 6914 | KS | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prairie View, Inc. | Past | Accepting new patients |
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.
-
- Psychiatric Hospital
- Wichita, KS
- NPI 1902251655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656547200000",
"number": "1508031543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 CITRUS TOWER BLVD",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347117012",
"telephone_number": "352-536-8200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 CITRUS TOWER BLVD",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347117012",
"telephone_number": "352-536-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANFORD",
"first_name": "OLGA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-29",
"last_updated": "2022-06-30",
"certification_date": "2022-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "KS",
"license": "6914",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "KS",
"license": "0435265",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME 123463",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "1K132Z",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "OLGA",
"last_name": "SANFORD KERECHES",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.