Active NPI
Sandra Mary Ann Soares, M.D.
- Pediatrics Physician
- Sylacauga, AL
National Provider Identifier
1619904695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 11261
- Practice address
- 291 James Payton Blvd
Sylacauga, AL 35150-8047 - Phone
- (256) 245-0297
- Fax
- (256) 245-0624
- NPI assigned
- Jun 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 11261 | AL | Primary |
Addresses
Primary practice location
291 James Payton Blvd
Sylacauga, AL 35150-8047
Mailing address
291 James Payton Blvd
Sylacauga, AL 35150-8047
Phone (256) 245-0297
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11261 | AL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379548800000",
"number": "1619904695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "291 JAMES PAYTON BLVD",
"city": "SYLACAUGA",
"state": "AL",
"postal_code": "351508047",
"telephone_number": "256-245-0297",
"fax_number": "256-245-0624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "291 JAMES PAYTON BLVD",
"city": "SYLACAUGA",
"state": "AL",
"postal_code": "351508047",
"telephone_number": "256-245-0297",
"fax_number": "256-245-0624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOARES",
"first_name": "SANDRA",
"middle_name": "MARY ANN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2013-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AL",
"license": "11261",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sylacauga, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.