Individual provider Active NPI

Sandra Sekul

  • Registered Nurse
  • Gulfport, MS
National Provider Identifier
1669936902
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
628336 Issued in SD
Practice address
1600 Broad Ave
Gulfport, MS 39501-3603
Phone
(228) 865-1719
Fax
(228) 865-1780
NPI assigned
Jan 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 628336 SD Primary

Addresses

Primary practice location

1600 Broad Ave
Gulfport, MS 39501-3603

Mailing address

1600 Broad Ave
Gulfport, MS 39501-3603
Phone (228) 865-1719

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
628336SDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1669936902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395013603",
            "telephone_number": "228-865-1719",
            "fax_number": "228-865-1780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395013603",
            "telephone_number": "228-865-1719",
            "fax_number": "228-865-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEKUL",
        "first_name": "SANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "628336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.