Kelly Dean Sanders, LSA

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

SA00575 Issued in TX

Practice address

7309 Winding Way Dr
Arlington, TX 76001-2006

Phone

(817) 714-9066

NPI assigned

May 21, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ksanders@direct.uspi.com

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.

• KDS Surgical Assisting, PLLC

  • Surgical Assistant
  • Arlington, TX
  • NPI 1104300789
  NPD Authorized official

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

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585353600000",
    "number": "1619296274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7309 WINDING WAY DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760012006",
            "telephone_number": "817-714-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7309 WINDING WAY DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760012006",
            "telephone_number": "817-714-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "KELLY",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "LSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-21",
        "last_updated": "2020-03-28",
        "certification_date": "2020-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "381",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "SA00575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Elena Sanchez, LVN
• Ayisha Sanda, PMHNP-BC, APRN-CNP
• Brittany Sanders, RBT
• Danielle Sanders, LPC-A
• Emily Mendoza Sanders
• Makea Sanders
• Sawroop Kaur Sandhu, M.D.
• Dale Sandvall, DC
• Sandy Smiles PLLC
• Deborah Ann Sanford-Wilson, APRN

• Surgical Assistant in Arlington, TX
• Providers in Arlington, TX by specialty
• Surgical Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2020; 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.