Individual provider Active NPI

Honora Manning Sandifer, M.D.

  • Psychiatry Physician
  • Gastonia, NC
National Provider Identifier
1659368280
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
200300524 Issued in NC
Practice address
2240 Remount Rd
Gastonia, NC 28054-4725
Phone
(704) 671-5344
Fax
(704) 671-5331
NPI assigned
Sep 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 200300524 NC Primary

Addresses

Primary practice location

2240 Remount Rd
Gastonia, NC 28054-4725

Mailing address

2240 Remount Rd
Gastonia, NC 28054-4725
Phone (704) 671-5311

Other identifiers 1

IdentifierTypeStateIssuer
89134FTMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20150112000590 SC Practitioner - Psychiatry 4486609310 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200300524NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palmetto Behavioral Health Solutions, LLC CurrentSince Oct 19, 2014 Accepting new patients
Palmetto Lowcountry Behavioral Health, LLC Past Accepting new patients

Locations

2777 Speissegger Dr
North Charleston, SC 29405
Phone (843) 266-7080

4500 Leeds Ave
Ste 219
North Charleston, SC 29405
Phone (843) 745-5178

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267142400000",
    "number": "1659368280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 REMOUNT RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544725",
            "telephone_number": "704-671-5311",
            "fax_number": "704-671-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 REMOUNT RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544725",
            "telephone_number": "704-671-5344",
            "fax_number": "704-671-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDIFER",
        "first_name": "HONORA",
        "middle_name": "MANNING",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2010-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "200300524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89134FT",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.