NPIMap

Individual provider Active NPI

Timothy Joseph Sanders, M.D.

  • Family Medicine Physician
  • Seneca, SC
National Provider Identifier
1679799605
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
LL28973 Issued in SC
Practice address
100 Omni Dr
Suite a
Seneca, SC 29672-9448
Phone
(864) 885-7520
Fax
(864) 885-7521
NPI assigned
Apr 18, 2007
Last updated
Sep 29, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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 LL28973 SC Primary

Addresses

Primary practice location

100 Omni Dr
Suite a
Seneca, SC 29672-9448

Mailing address

1 Independence PT
Suite 212
Greenville, SC 29615-4545
Phone (864) 797-6044

Other identifiers 3

IdentifierTypeStateIssuer
GP4697MedicaidSC
289734MedicaidSC
20-8715655OtherSCTAX ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090910000436 SC Practitioner - Family Practice 0446305734 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Community Health CareGroup PAC ID 8628227667, shared by 3 NPIs, 10 clinicians

Practice addresses (Care Compare)

302 Pearman Dairy Rd
Suite C1
Anderson, SC 29625-3802
Phone (864) 224-0822

403 Hillcrest Dr
Suite E
Easley, SC 29640-1207
Phone (864) 722-0283

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL28973SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Oct 1, 2014 Accepting new patients
Foothills Community Health Care, Inc CurrentSince Oct 12, 2021 Accepting new patients
Foothills Community Health Care, Inc. CurrentSince Jan 2, 2020 Accepting new patients
Greenville Health System CurrentSince Mar 22, 2015 Accepting new patients
Prisma Health University Medical Group Family Medicine CurrentSince Oct 1, 2016 Accepting new patients
Foothills Community Health Care, Inc CurrentSince Jan 2, 2020 Accepting new patients
Greenville Health System Current Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Greenville Health System CurrentSince Mar 22, 2015 Accepting new patients
GHS Partners in Health, Inc. Family Medicine CurrentSince Oct 1, 2014 Accepting new patients
Foothills Community Health Care, Inc. Family Medicine CurrentSince Jan 2, 2020 Accepting new patients
Foothills Community Health Care, Inc. Past Accepting new patients

Locations

302 Pearman Dairy Rd
Ste C1
Anderson, SC 29625
Phone (864) 633-5171

110 Liberty Dr
Clemson, SC 29631
Phone (864) 722-0283

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

403 Hillcrest Dr
Easley, SC 29640
Phone (864) 343-1220

403 Hillcrest Dr
Ste E
Easley, SC 29640
Phone (864) 343-1220

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

100 Omni Dr
#A
Seneca, SC 29672
Phone (864) 885-7520

10110 Clemson Blvd
Seneca, SC 29678
Phone (864) 482-0500

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

772 N Townville St
Seneca, SC 29678
Phone (864) 886-9300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/fhir/r4
  • Direct secure messaging: timothy.sanders.1@30137.direct.athenahealth.com

Organizations & group practices 12

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 4

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411948800000",
    "number": "1679799605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 OMNI DR",
            "address_2": "SUITE A",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296729448",
            "telephone_number": "864-885-7520",
            "fax_number": "864-885-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "TIMOTHY",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2014-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL28973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4697",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "289734",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "20-8715655",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, SC

Sources for this page

Verify at the official NPI Registry.