Individual provider Active NPI

Lara Sanders, APN

  • Adult Health Nurse Practitioner
  • Little Rock, AR
National Provider Identifier
1508252644
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A004421 Issued in AR
Practice address
2500 E 6TH St
Little Rock, AR 72202-3008
Phone
(501) 552-4710
Fax
(501) 376-2084
NPI assigned
Apr 15, 2015
Last updated
Apr 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AG0215073 AR
Adult Health Nurse Practitioner 363LA2200X A004421 AR Primary

Addresses

Primary practice location

2500 E 6TH St
Little Rock, AR 72202-3008

Mailing address

2500 E 6TH St
Little Rock, AR 72202-3008
Phone (501) 552-4710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150805006585 AR Practitioner - Nurse Practitioner 0648584656 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Vincent Medical GroupGroup PAC ID 5698758803, 237 clinicians

Practice addresses (Care Compare)

7709 Hwy 107
Sherwood, AR 72120-4661
Phone (501) 552-7269

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A004421ARMDAdult Health Nurse Practitioner
AG0215073ARMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group CurrentSince Jun 8, 2015 Accepting new patients
St Vincent Physician Clinics LLC Past Accepting new patients

Locations

1110 W Main St
Jacksonville, AR 72076
Phone (501) 982-2108

16221 Saint Vincent Way
Little Rock, AR 72223
Phone (501) 221-0888

2500 E 6th St
Little Rock, AR 72202
Phone (501) 376-2007

7709 Highway 107
Sherwood, AR 72120
Phone (501) 552-7262

Interoperability endpoints

  • Direct secure messaging: lara.sanders@rcwawll-ar.direct.office.nextgen.com
  • Direct secure messaging: lara.sanders@svmgs.eclinicaldirectplus.com
  • Direct secure messaging: lsanders458313@direct.stlukeshealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1508252644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E 6TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023008",
            "telephone_number": "501-552-4710",
            "fax_number": "501-376-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E 6TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023008",
            "telephone_number": "501-552-4710",
            "fax_number": "501-376-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "LARA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "AG0215073",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AR",
            "license": "A004421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.