Active NPI
Armando C Sandoval, M.D.
- Family Medicine Physician
- Henderson, KY
National Provider Identifier
1659389294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 21335
- Practice address
- 1413 N Elm St
Suite 101
Henderson, KY 42420-2768 - Phone
- (270) 827-9803
- Fax
- (270) 827-8966
- NPI assigned
- Aug 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 21335 | KY | Primary |
Addresses
Primary practice location
1413 N Elm St
Suite 101
Henderson, KY 42420-2768
Mailing address
1413 N Elm St
Henderson, KY 42420-2768
Phone (270) 827-9803
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21335 | Other | KY | KY LICENSE |
| 64213358 | Medicaid | KY | |
| 080113180 | Other | KY | KY RR MCR |
| 000000047428 | Other | KY | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101208001155 | KY | Practitioner - Family Practice | 6002953395 | Practice locations: Henderson, KY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438560000000",
"number": "1659389294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1413 N ELM ST",
"city": "HENDERSON",
"state": "KY",
"postal_code": "424202768",
"telephone_number": "270-827-9803",
"fax_number": "270-827-8966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1413 N ELM ST",
"address_2": "SUITE 101",
"city": "HENDERSON",
"state": "KY",
"postal_code": "424202768",
"telephone_number": "270-827-9803",
"fax_number": "270-827-8966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOVAL",
"first_name": "ARMANDO",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2015-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "21335",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KY LICENSE",
"identifier": "21335",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64213358",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KY RR MCR",
"identifier": "080113180",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000047428",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Henderson, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.