Individual provider Active NPI

Suzanne Ellen Sanderson, FNP-C

  • Family Nurse Practitioner
  • Ashland, OR
National Provider Identifier
1770005407
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201707770NP-PP Issued in OR
Practice address
148 E Hersey St
Ashland, OR 97520-1359
Phone
(541) 326-4777
NPI assigned
Jul 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201707770NP-PP OR Primary

Addresses

Primary practice location

148 E Hersey St
Ashland, OR 97520-1359

Mailing address

2620 E Barnett Rd Ste H
Medford, OR 97504-8383
Phone (541) 789-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20171130001358 OR Practitioner - Nurse Practitioner 2264799113 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

148 E Hersey St
Ashland, OR 97520-1359

Hospital & facility affiliations

  • Assured Home Health Home health agency, Grants Pass, OR, CCN 387076
  • Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Providence Medford Medical Center Hospital, Medford, OR, CCN 380075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201707770NP-PPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2021 Accepting new patients
Monarque Health and Wellness LLC CurrentSince Oct 1, 2019 Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 1, 2021 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients

Locations

148 E Hersey St
Ashland, OR 97520
Phone (541) 326-4777

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

Interoperability endpoints

  • Direct secure messaging: suzanne.sanderson.1@12515.direct.athenahealth.com
  • Direct secure messaging: suzanne.sanderson.1@15895.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/15895/brand/1/csg/1/fhir/r4

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.

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": "1499990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1770005407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 E BARNETT RD STE H",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048383",
            "telephone_number": "541-789-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 E HERSEY ST",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201359",
            "telephone_number": "541-326-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "SUZANNE",
        "middle_name": "ELLEN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-14",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201707770NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, OR

Sources for this page

Verify at the official NPI Registry.