Individual provider Active NPI

Sandra Stroud Yamane, AGNP-C

  • Primary Care Nurse Practitioner
  • Mocksville, NC
National Provider Identifier
1609347848
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
5010204 Issued in NC
Practice address
675 E Lexington Rd
Mocksville, NC 27028-2625
Phone
(336) 751-2325
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 5010204 NC Primary

Addresses

Primary practice location

675 E Lexington Rd
Mocksville, NC 27028-2625

Mailing address

300 N Hawthorne Rd
Winston Salem, NC 27104-3202
Phone (336) 402-2597

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

State licenses

LicenseStateTypeSpecialty
5010204NCMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1609347848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043202",
            "telephone_number": "336-402-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 E LEXINGTON RD",
            "city": "MOCKSVILLE",
            "state": "NC",
            "postal_code": "270282625",
            "telephone_number": "336-751-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMANE",
        "first_name": "SANDRA",
        "middle_name": "STROUD",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5010204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mocksville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.