David Anthony Sandoval, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

224084 Issued in SC

Practice address

403 Buncombe St
Edgefield, SC 29824-1012

Phone

(803) 221-5367

NPI assigned

Apr 18, 2019

Last updated

Apr 18, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Med Now Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Evans, GA
  • NPI 1245475771
  Medicare reassignment NPD
• Urgent MD Healthcare Services, P.C.

  dba Urgent MD, LLC

  • Family Medicine Physician
  • Grovetown, GA
  • NPI 1053482273
  Medicare reassignment

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1750944401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 BUNCOMBE ST",
            "city": "EDGEFIELD",
            "state": "SC",
            "postal_code": "298241012",
            "telephone_number": "803-221-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 BUNCOMBE ST",
            "city": "EDGEFIELD",
            "state": "SC",
            "postal_code": "298241012",
            "telephone_number": "803-221-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "DAVID",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "224084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Rainsford, RN
• Austin N Rampey, MD
• River Road Care
• Julian Thomas Rushin, RPH
• Kathleen M Ryan, PT
• SC-Ga2018 the Ridge Rehabilitation and Healthcare Center, LLC (The Ridge Rehabilitation and Healthcare Center)
• Self Regional Healthcare Partners (Edgefield Medical Center)
• Self Regional Healthcare Partners (Edgefield Community Pharmacy)
• Self Regional Healthcare Partners (Edgefield Medical Center)
• Self Regional Healthcare Partners (ECH Swing Bed, An Affiliate of Self Regional Healthcare)

• Family Nurse Practitioner in Edgefield, SC
• Providers in Edgefield, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.