Zackery Lee Sanders

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

5381229 Issued in ID

Practice address

2619 W Fairview Ave
Boise, ID 83702-6722

Phone

(208) 706-9300

Fax

(208) 489-4300

NPI assigned

Apr 11, 2022

Last updated

Aug 27, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1649912510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2619 W FAIRVIEW AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026722",
            "telephone_number": "208-706-9300",
            "fax_number": "208-489-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "ZACKERY",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-11",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "ID",
            "license": "5381229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanders Dental PLLC
• Carlean M Sanders, MD
• Casey Dale Sanders, DMD
• Eric William Sanders, OTR/L
• Lester Sanders III, M.D.
• Thomas Sanderson, MD
• Ariel Sandifer, FNP
• Megan Sandmann, MD
• Ranan Grace Sandmeyer, NP-C
• Tamara Sandmeyer, NP-C

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Boise, ID
• Providers in Boise, ID by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.