Individual provider Active NPI

Sherri Sanford, PA C

  • Family Medicine Physician
  • Clermont, FL
National Provider Identifier
1669542445
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PA 3267 Issued in FL
Practice address
1135 Lake Ave
Clermont, FL 34711
Phone
(352) 394-4035
Fax
(352) 241-0896
NPI assigned
Nov 8, 2006
Last updated
Sep 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA 3267 FL Primary

Addresses

Primary practice location

1135 Lake Ave
Clermont, FL 34711

Mailing address

PO Box 121009
Clermont, FL 34712
Phone (352) 394-4035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050411000243 FL Practitioner - Physician Assistant 6507803764 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA 3267FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emmanuel Christian Health Center PA PastSince Apr 1, 1998 Accepting new patients
Center for Sleep and Lung Disorders Inc PastSince May 29, 2007 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1669542445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 121009",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "34712",
            "telephone_number": "352-394-4035",
            "fax_number": "352-241-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 LAKE AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "34711",
            "telephone_number": "352-394-4035",
            "fax_number": "352-241-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "SHERRI",
        "credential": "PA C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "PA 3267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.