Sandra A. Agnes, CNP – Family Nurse Practitioner

Key facts

NPI: 1710218433
Entity type: Individual (NPI type 1)
Primary specialty: Family Nurse Practitioner 363LF0000X
License: COA11157NP (OH)
Practice address: 400 Medical Park Drive
Suite 201
Dover, OH 44622
Phone: (330) 343-7709
Fax: (330) 364-1538
NPI assigned: Jan 20, 2010
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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

Union Physician Services, LLC Family Medicine Physician · Dover, OH · NPI 1215169826

Medicare reassignment Care Compare group NPD OH

Hospital & facility affiliations 2

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

The Cleveland Clinic Foundation General Acute Care Hospital · Cleveland, OH · NPI 1679525919

Care Compare affiliation Hospital
The Union Hospital Association Rural Acute Care Hospital · Dover, OH · NPI 1871606921

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Nurse Practitioner
Education: Other, 2009
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Union Physician Services LLC (97 clinicians)

Practice addresses (Care Compare)

205 Hospital Dr
Dover, OH 44622-2058
Phone (330) 343-7950

Hospital & facility affiliations

Union Hospital Hospital · Dover, OH · CCN 360010
Cleveland Clinic Hospital · Cleveland, OH · CCN 360180

Medicare participation

Medicare fee-for-service enrollment: Enrolled in OH
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20110907001299	OH	Practitioner - Nurse Practitioner	3476723149	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Certified Nurse Practitioner, Nurse Practitioner

State licenses

License	State	Type	Specialty
COA11157NP	OH	MD	Family Nurse Practitioner

Practice roles

Organization	Specialty	Status	New patients
Union Physician Services, LLC		Current since Dec 26, 2014	Accepting new patients

Locations

110 Dublin Dr
#A
Dover, OH 44622
Phone (330) 364-8038

400 Medical Park Dr
Ste 201
Dover, OH 44622
Phone (330) 343-7709

205 Hospital Dr
Dover, OH 44622
Phone (330) 343-3335

110 Dublin Dr
Dover, OH 44622
Phone (330) 343-0753

Interoperability endpoints

Direct secure messaging: sandraagnes@dpfm.allscriptsdirect.net
Direct secure messaging: sagnes1237508@direct.ccf.org

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner	363LF0000X	COA11157NP	OH	Yes

Addresses

Primary practice location

400 Medical Park Drive
Suite 201
Dover, OH 44622

Mailing address

400 Medical Park Drive
Suite 201
Dover, OH 44622
Phone (330) 343-7709

Other providers in Dover, OH

Aaron C. Lahman, OD, LTD
Dawn Abrams, RN
Access Tusc
Ashley Marie Addessi-Durnell, R.D., L.D.
Daryl Adelman, DPT
Maaz Ahmed, MD
Sumayya Ahmed, MD
Mohammed Hassan Albahrani I
Bethany Lynn Albaugh, APRN,PMHNP
Alexis Albrecht

All providers in Dover, OH · Family Nurse Practitioner in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.