Individual provider Active NPI

Alicia Pearl Sanders, APRN

  • Family Nurse Practitioner
  • Tahlequah, OK
National Provider Identifier
1669125753
Registry record updated Feb 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
206104 Issued in OK
Practice address
228 N Bliss Ave
Tahlequah, OK 74464-2520
Phone
(918) 506-6920
Fax
(918) 506-6993
NPI assigned
Jan 31, 2022
Last updated
Feb 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 206104 OK
Family Nurse Practitioner 363LF0000X 206104 OK Primary

Addresses

Primary practice location

228 N Bliss Ave
Tahlequah, OK 74464-2520

Mailing address

1400 E Downing St
Tahlequah, OK 74464-3324
Phone (918) 456-0641

Other practice location 1

1323 W Keetoowah St
Tahlequah, OK 74464-3462
Phone (918) 931-3890

Other practice location 2

301 N 32nd St
Muskogee, OK 74401-2106
Phone (918) 683-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220727004155 OK Practitioner - Nurse Practitioner 7810379542 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tahlequah Medical Group LLCGroup PAC ID 4082861349, 16 clinicians
Northeastern Health SystemGroup PAC ID 1456255025, 105 clinicians

Practice addresses (Care Compare)

1323 W Keetoowah St
Tahlequah, OK 74464-3462
Phone (918) 931-3890

1400 E Downing St
Tahlequah, OK 74464-3324
Phone (918) 456-0641

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northeastern Health System CurrentSince Jul 1, 2022 Accepting new patients
Northeastern Health System CurrentSince Jul 1, 2022 Accepting new patients
Northeastern Health System Current Accepting new patients
Tahlequah Medical Group LLC CurrentSince Feb 1, 2025 Accepting new patients
Warren Clinic Inc PastSince Feb 1, 2022 Accepting new patients
Muskogee Medical and Surgical Associates, LLC PastSince Feb 1, 2022 Accepting new patients

Locations

1323 W Keetoowah St
Tahlequah, OK 74464
Phone (918) 708-3006

1400 E Downing St
Tahlequah, OK 74464
Phone (918) 456-0641

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2065/brand/5/csg/1/fhir/r4
  • FHIR API: https://fhir-myrecord.cerner.com/r4/932b43fb-c766-413c-a343-640549d20cb3/

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1643587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1669125753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E DOWNING ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643324",
            "telephone_number": "918-456-0641",
            "fax_number": "918-453-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 N BLISS AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744642520",
            "telephone_number": "918-506-6920",
            "fax_number": "918-506-6993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1323 W Keetoowah St",
            "address_purpose": "LOCATION",
            "city": "Tahlequah",
            "state": "OK",
            "postal_code": "744643462",
            "country_code": "US",
            "telephone_number": "918-931-3890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 N 32nd St",
            "address_purpose": "LOCATION",
            "city": "Muskogee",
            "state": "OK",
            "postal_code": "744012106",
            "country_code": "US",
            "telephone_number": "918-683-2000",
            "fax_number": "918-686-0554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "ALICIA",
        "middle_name": "PEARL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-31",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "206104",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "206104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

Verify at the official NPI Registry.