Individual provider Active NPI

Rebecca L. Sanderson, MD

  • Orthopaedic Surgery Physician
  • Petersburg, VA
National Provider Identifier
1508203449
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
0101257948 Issued in VA
Practice address
3335 S Crater Rd Ste 500
Petersburg, VA 23805-9396
Phone
(804) 504-4610
Fax
(804) 709-0041
NPI assigned
Jun 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 12792808-1205 UT
Orthopaedic Surgery Physician 207X00000X 0101257948 VA Primary
Orthopaedic Surgery Physician 207X00000X DR.0062586 CO

Addresses

Primary practice location

3335 S Crater Rd Ste 500
Petersburg, VA 23805-9396

Mailing address

PO Box 639969
Cincinnati, OH 45263-9969

Other practice location 1

4102 Pinion Dr
Usaf Academy, CO 80840
Phone (719) 333-5040

Other practice location 2

51 MDG
Unit 2060
Apo, AP 96278-2060
Phone (031) 661-2546

Other practice location 3

51 MDG
Unit 2060
Apo, AP 96278-2060
Phone (031) 661-2546

Other practice location 4

590 S Wakara Way
Salt Lake City, UT 84108-1200
Phone (801) 587-5448

Other practice location 5

401 N 11th St
Ortho: Orthopaedic Surgery Clinic
Richmond, VA 23298-5024
Phone (804) 828-7394

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RSANDERSON580357@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230927000085 VA Practitioner - Orthopedic Surgery 3971743642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Virginia Commonwealth University, School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Medical Group Richmond Specialty Care LLCGroup PAC ID 8022440056, 350 clinicians

Practice addresses (Care Compare)

1510 N 28TH St
Richmond, VA 23223-5311

40 Medical Park Blvd
Petersburg, VA 23805-9289

44 Medical Park Blvd
Petersburg, VA 23805-9351

Hospital & facility affiliations

  • Bon Secours Southside Medical Center Hospital, Petersburg, VA, CCN 490067
  • Bon Secours St Francis Medical Center Hospital, Midlothian, VA, CCN 490136
  • Bon Secours Southern Virginia Medical Center Hospital, Emporia, VA, CCN 490097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0062586COMDOrthopaedic Surgery Physician
0101257948VAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC Orthopaedic Surgery CurrentSince Sep 5, 2023 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC Orthopaedic Surgery CurrentSince Sep 5, 2023 Accepting new patients

Locations

3335 S Crater Rd
Ste 500
Petersburg, VA 23805
Phone (804) 504-4610

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

Interoperability endpoints

  • Direct secure messaging: rsanderson580357@direct.med.utah.edu

Organizations & group practices 2

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1370131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1508203449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639969",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 S CRATER RD STE 500",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059396",
            "telephone_number": "804-504-4610",
            "fax_number": "804-709-0041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4102 Pinion Dr",
            "address_purpose": "LOCATION",
            "city": "Usaf Academy",
            "state": "CO",
            "postal_code": "80840",
            "country_code": "US",
            "telephone_number": "719-333-5040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "51 MDG",
            "address_2": "Unit 2060",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AP",
            "postal_code": "962782060",
            "country_code": "US",
            "telephone_number": "031-661-2546",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "51 MDG",
            "address_2": "Unit 2060",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AP",
            "postal_code": "962782060",
            "country_code": "US",
            "telephone_number": "031-661-2546",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "590 S Wakara Way",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841081200",
            "country_code": "US",
            "telephone_number": "801-587-5448",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 N 11th St",
            "address_2": "ORTHO: ORTHOPAEDIC SURGERY CLINIC",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985024",
            "country_code": "US",
            "telephone_number": "804-828-7394",
            "fax_number": "804-628-1522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "REBECCA",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-02",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "UT",
            "license": "12792808-1205",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "VA",
            "license": "0101257948",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CO",
            "license": "DR.0062586",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RSANDERSON580357@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

Verify at the official NPI Registry.