Active NPI
Susan K Sanders, PHD
- Psychologist
- Phillips, ME
National Provider Identifier
1528088697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS1134
- Practice address
- 43 Main Street
Phillips, ME 04966 - Phone
- (207) 639-2419
- Fax
- (207) 639-2305
- NPI assigned
- Jul 20, 2006
- Last updated
- Nov 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS1134 | ME | Primary |
Addresses
Primary practice location
43 Main Street
Phillips, ME 04966
Mailing address
43 Main Street
Phillips, ME 04966
Phone (207) 639-2419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ME
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051102000800 | ME | Practitioner - Clinical Psychologist | 5991723512 | Practice locations: Phillips, ME |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
43 Main St
Phillips, ME 04966-4400
Phone (207) 639-2419
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS1134 | ME | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352937600000",
"number": "1528088697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 MAIN STREET",
"city": "PHILLIPS",
"state": "ME",
"postal_code": "04966",
"telephone_number": "207-639-2419",
"fax_number": "207-639-2305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43 MAIN STREET",
"city": "PHILLIPS",
"state": "ME",
"postal_code": "04966",
"telephone_number": "207-639-2419",
"fax_number": "207-639-2305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "SUSAN",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2012-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "ME",
"license": "PS1134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phillips, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.