Kenneth Michael Sanders, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

000443 Issued in TN

Practice address

923 E Central Ave
La Follette, TN 37766-2768

Phone

(423) 907-1200

Fax

(865) 291-3228

NPI assigned

Jun 5, 2006

Last updated

Dec 4, 2007By the provider in NPPES

Sex

Male

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

• Southeastern Emergency Services P C

  • Nurse Practitioner
  • Athens, TN
  • NPI 1669414264

  Physician Assistant

  NPD (past)
• University Health System Inc

  dba University Thoracic Surgeons

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Knoxville, TN
  • NPI 1306609748
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1578502696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 COVE POINTE RD",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377665945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 E CENTRAL AVE",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377662768",
            "telephone_number": "423-907-1200",
            "fax_number": "865-291-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "000443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4108109",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00310586",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Jean Rose, P.A.
• Bethany Runions, FNP-C
• Kerry Rupe
• Deborah Lynn Russell, BSN, MSN, FNP
• Jean Russell, CRNA
• Kimberly Jayne Schmieder, PTA
• Lee Seargeant III, PHARMACIST
• Curtis Cecil Sexton, MD
• James F.Ranklin Shaw, DMD
• Nanji Shekhat, MD

• Physician Assistant in La Follette, TN
• Providers in La Follette, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.