Individual provider Active NPI

Emily B. Sanderson, PNP

  • Pediatric Nurse Practitioner
  • Apopka, FL
National Provider Identifier
1578857330
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
9489567 Issued in FL
Practice address
425 S Hunt Club Blvd Ste 1051
Apopka, FL 32703-2428
Phone
(407) 786-4080
NPI assigned
Jun 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 223076 NC
Pediatric Nurse Practitioner 363LP0200X 0024171559 VA
Pediatric Nurse Practitioner 363LP0200X 9489567 FL Primary

Addresses

Primary practice location

425 S Hunt Club Blvd Ste 1051
Apopka, FL 32703-2428

Mailing address

425 S Hunt Club Blvd Ste 1051
Apopka, FL 32703-2428
Phone (407) 786-4080

Other practice location 1

817 Davis St Ste A
Blacksburg, VA 24060-7004
Phone (540) 443-3940

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
9489567FLMDPediatric Nurse Practitioner
223076NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health First Medical Group, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1578857330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 S HUNT CLUB BLVD STE 1051",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327032428",
            "telephone_number": "407-786-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S HUNT CLUB BLVD STE 1051",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327032428",
            "telephone_number": "407-786-4080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "817 Davis St Ste A",
            "address_purpose": "LOCATION",
            "city": "Blacksburg",
            "state": "VA",
            "postal_code": "240607004",
            "country_code": "US",
            "telephone_number": "540-443-3940",
            "fax_number": "540-443-3944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "EMILY",
        "middle_name": "B.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-08",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "223076",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024171559",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "9489567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.