Individual provider Active NPI

Sanford Guttler, M.D.

  • Family Medicine Physician
  • Granite Falls, NC
National Provider Identifier
1629057336
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7923284 Issued in NC
Practice address
1 Trade St
Granite Falls, NC 28630-1525
Phone
(828) 396-3136
Fax
(828) 396-3105
NPI assigned
Jan 11, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X 23284 NC
Family Medicine Physician 207Q00000X 7923284 NC Primary

Addresses

Primary practice location

1 Trade St
Granite Falls, NC 28630-1525

Mailing address

PO Box 249
Conover, NC 28613-0249
Phone (828) 465-9730

Other identifiers 2

IdentifierTypeStateIssuer
790148FMedicaidNC
CN8132OtherNCMEDICARE RAILROAD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050401000610 NC Practitioner - Family Practice 8527015551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23284NCMDPharmacist
7923284NCMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1629057336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286130249",
            "telephone_number": "828-465-9730",
            "fax_number": "828-465-9293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 TRADE ST",
            "city": "GRANITE FALLS",
            "state": "NC",
            "postal_code": "286301525",
            "telephone_number": "828-396-3136",
            "fax_number": "828-396-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTTLER",
        "first_name": "SANFORD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "NC",
            "license": "23284",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "7923284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790148F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CN8132",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite Falls, NC

Sources for this page

Verify at the official NPI Registry.