NPIMap

Individual provider Active NPI

Stacy Ann Sanders, ARNP

  • Acute Care Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1679187603
Registry record updated Dec 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
27220 Issued in SC
Practice address
1655 Bernardin Ave Ste 220
Columbia, SC 29204-2044
Phone
(843) 792-1414
NPI assigned
Sep 8, 2020
Last updated
Dec 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN61073477 WA
Acute Care Nurse Practitioner 363LA2100X AP61105297 WA
Acute Care Nurse Practitioner 363LA2100X 27220 SC Primary

Addresses

Primary practice location

1655 Bernardin Ave Ste 220
Columbia, SC 29204-2044

Mailing address

PO Box 23321
New York, NY 10087-3321
Phone (843) 792-6200

Other identifiers 1

IdentifierTypeStateIssuer
1679187603MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230515002322 SC Practitioner - Nurse Practitioner 7012337835 Reassigns benefits to 1 organization
I20260520003138 NC Practitioner - Nurse Practitioner 7012337835 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

805 Pamplico Hwy
Florence, SC 29505-6047
Phone (843) 792-1414

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN61073477WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Sep 20, 2024 Accepting new patients
Musc Community Physicians Current Accepting new patients
Musc Community Physicians CurrentSince Sep 20, 2024 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1655 Brabham Ave
Ste 220
Columbia, SC 29204
Phone (803) 254-5038

805 Pamplico Hwy
Ste A220
Florence, SC 29505
Phone (803) 664-9393

Interoperability endpoints

  • Direct secure messaging: ssanders195549@direct.musc.edu

Organizations & group practices 6

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": "1599523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766534400000",
    "number": "1679187603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23321",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873321",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 BERNARDIN AVE STE 220",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292042044",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "STACY",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-08",
        "last_updated": "2025-12-24",
        "certification_date": "2025-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "RN61073477",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WA",
            "license": "AP61105297",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "27220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679187603",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.