Individual provider Active NPI

Sanniya Nanda, MD

  • Pediatrics Physician
  • Fayetteville, NC
National Provider Identifier
1710416490
Registry record updated Feb 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
202000252 Issued in NC
Practice address
1327 Robeson St
Fayetteville, NC 28305-5531
Phone
(910) 486-5437
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 202000252 NC Primary

Addresses

Primary practice location

1327 Robeson St
Fayetteville, NC 28305-5531

Mailing address

937 Liberty LN
Fayetteville, NC 28311-3073
Phone (919) 397-2421

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251202000636 WV Practitioner - Pediatric Medicine 5294088548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

203 E 4TH Ave
Ranson, WV 25438-1617

PO Box
Suite 780
Morgantown, WV 26507-0780

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202000252NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rainbow Pediatrics of Fayetteville Single Specialty CurrentSince Feb 24, 2022 Accepting new patients
West Virginia University Medical Corporation Single Specialty CurrentSince Nov 11, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Nov 11, 2025 Accepting new patients
Rainbow Pediatrics Single Specialty PastSince Feb 24, 2022 Accepting new patients

Locations

1327 Robeson St
Fayetteville, NC 28305
Phone (910) 486-5437

341 S McPherson Church Rd
Fayetteville, NC 28303
Phone (910) 920-4428

4469 S Main St
Hope Mills, NC 28348
Phone (910) 426-5430

142 Paraclete Dr
Ste 102
Raeford, NC 28376

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

203 E 4th Ave
Ranson, WV 25438
Phone (304) 535-6343

Interoperability endpoints

  • Direct secure messaging: sanniyananda@rpf.allscriptsdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1710416490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "937 LIBERTY LN",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283113073",
            "telephone_number": "919-397-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 ROBESON ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055531",
            "telephone_number": "910-486-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANDA",
        "first_name": "SANNIYA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "202000252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.