Individual provider Active NPI

Sandra Boardman Harper, NP

  • Family Nurse Practitioner
  • Conroe, TX
National Provider Identifier
1518900596
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP109254 Issued in TX
Practice address
506 Medical Center Blvd
Ste. 304
Conroe, TX 77304-2826
Phone
(888) 624-6882
Fax
(888) 395-9138
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 595011 TX
Family Nurse Practitioner 363LF0000X AP109254 TX Primary

Addresses

Primary practice location

506 Medical Center Blvd
Ste. 304
Conroe, TX 77304-2826

Mailing address

3500 Hillcrest Dr
Ste. 1
Waco, TX 76708-3157
Phone (888) 624-6882

Other identifiers 1

IdentifierTypeStateIssuer
041471603MedicaidTX

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP109254TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1518900596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 HILLCREST DR",
            "address_2": "STE. 1",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767083157",
            "telephone_number": "888-624-6882",
            "fax_number": "888-395-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MEDICAL CENTER BLVD",
            "address_2": "STE. 304",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042826",
            "telephone_number": "888-624-6882",
            "fax_number": "888-395-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARPER",
        "first_name": "SANDRA",
        "middle_name": "BOARDMAN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "595011",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP109254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041471603",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.