Individual provider Active NPI

Mary K Sandelski, RNC, CNM

  • Registered Nurse
  • Valparaiso, IN
National Provider Identifier
1598905564
Registry record updated Mar 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
28105682A Issued in IN
Practice address
2803 Boilermaker CT.
Suite 1-F
Valparaiso, IN 46383
Phone
(219) 462-5976
NPI assigned
Mar 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28105682A IN Primary
Midwife 176B00000X 09000073A IN

Addresses

Primary practice location

2803 Boilermaker CT.
Suite 1-F
Valparaiso, IN 46383

Mailing address

P.O. Box 397
Indianapolis, IN 46206-0397
Phone (317) 637-4343

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)
Not enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
28105682AINMDRegistered Nurse
09000073AINMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Indiana Valparaiso Past Accepting new patients
Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1598905564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 397",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462060397",
            "telephone_number": "317-637-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 BOILERMAKER CT.",
            "address_2": "SUITE 1-F",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "46383",
            "telephone_number": "219-462-5976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDELSKI",
        "first_name": "MARY",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "RNC, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28105682A",
            "primary": true
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "IN",
            "license": "09000073A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; 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.