Sandra Lee Jarvis, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

200017 Issued in NC

Practice address

6255 Towncenter Dr Ste 810
Clemmons, NC 27012-9376

Phone

(980) 533-0993

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Carolinas Physicians Network Inc

  • Pediatrics Physician
  • Charlotte, NC
  • NPI 1619582343
  NPD (past)
• South Lake Pediatrics

  • Pediatrics Physician
  • Huntersville, NC
  • NPI 1295766079
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720127145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 TOWNCENTER DR STE 810",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129376",
            "telephone_number": "980-533-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 TOWNCENTER DR STE 810",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129376",
            "telephone_number": "980-533-0993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9625 Northcross Center Court",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787300",
            "country_code": "US",
            "telephone_number": "704-801-3097",
            "fax_number": "704-896-2344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "0050-00468",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "200017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70003712",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3666",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James E Rice, DDS PA
• James E. Rice DDS PA
• Brittany Miles James, NP
• Holly Anne Jamison, FNP-BC
• Kimberly Janvier, DNP, FNP-BC, APRN
• Stephanie Marie Jasso
• Caitlin Evey Jennings
• Kyle Joseph Jensen
• Candice Darcy Johnson-Leonard, ANP-C
• Kimberly D Johnson

• Nurse Practitioner in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.