Shirley Joanne Sanders, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71000212 Issued in IN

Practice address

3203 Middle Road
Columbus, IN 47203-4427

Phone

(812) 373-2700

Fax

(812) 373-2710

NPI assigned

May 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Shirley Joanne Bruenjes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)
• Cristo Rey Community Center

  • Addiction (Substance Use Disorder) Counselor
  • Lansing, MI
  • NPI 1700901964
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1558329292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 JACKSON ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472016264",
            "telephone_number": "812-748-3412",
            "fax_number": "812-377-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 MIDDLE ROAD",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472034427",
            "telephone_number": "812-373-2700",
            "fax_number": "812-373-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "SHIRLEY",
        "middle_name": "JOANNE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71000212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000990928",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "054962P",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201085480",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "500011512",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IN NP LINCENSE",
            "identifier": "71000212",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1407861164",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRLEY",
            "last_name": "BRUENJES",
            "middle_name": "JOANNE",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sandcrest Dental Health Associates, P.C.
• Sandcrest Dental Health LLC
• Amber Sanders, RN
• Anthony D Sanders, MD
• Christine Marie Sanders, SLP
• Abril Santana, RBT
• Monica Santana, RBT
• Kristen K Sasena, MS, LAT, ATC, CEIS
• Sruthi Sasi Prakash
• Satcher PT

• Family Nurse Practitioner in Columbus, IN
• Providers in Columbus, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.