Individual provider Active NPI

Ingrid Sandahl, NP-C

  • Nurse Practitioner
  • Forest City, NC
National Provider Identifier
1609217793
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
230135 Issued in NC
Practice address
181 Daniel Rd
Forest City, NC 28043-7151
Phone
(828) 286-9036
Fax
(828) 286-1079
NPI assigned
Jul 17, 2013
Last updated
Jan 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 230135 NC Primary
Nurse Practitioner 363L00000X F0713305 NC

Addresses

Primary practice location

181 Daniel Rd
Forest City, NC 28043-7151

Mailing address

PO Box 602148
Charlotte, NC 28260-2148
Phone (828) 286-9036

Other identifiers 2

IdentifierTypeStateIssuer
1609217793MedicaidNC
NP2479MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131023001406 NC Practitioner - Nurse Practitioner 6709011976 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 N Justice St
Hendersonville, NC 28791-3410
Phone (828) 696-4284

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.39 of 100Reported as apm
Quality
77.7
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F0713305NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson County Hospital Corporation CurrentSince Jul 8, 2016 Accepting new patients
Gastonia Physician Services, PLLC CurrentSince Jul 1, 2014 Accepting new patients
Western Carolina Emergency Physicians, PLLC CurrentSince Mar 15, 2016 Accepting new patients
Gastonia Physician Services, PLLC CurrentSince Jul 1, 2014 Accepting new patients
Henderson County Hospital Corporation CurrentSince Jul 8, 2016 Accepting new patients
The Carolinas Emergency Group, PLLC CurrentSince Nov 10, 2015 Accepting new patients

Locations

301 Yadkin St
Albemarle, NC 28001
Phone (704) 984-4000

21 Turtle Creek Dr
Ste 100
Asheville, NC 28803
Phone (828) 435-8394

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

800 N Justice St
Hendersonvlle, NC 28791
Phone (828) 696-1000

600 Hospital Dr
Monroe, NC 28112
Phone (704) 283-3100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1609217793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602148",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602148",
            "telephone_number": "828-286-9036",
            "fax_number": "828-286-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 DANIEL RD",
            "city": "FOREST CITY",
            "state": "NC",
            "postal_code": "280437151",
            "telephone_number": "828-286-9036",
            "fax_number": "828-286-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDAHL",
        "first_name": "INGRID",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "230135",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "F0713305",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609217793",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2479",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest City, NC

Sources for this page

Verify at the official NPI Registry.