Active NPI
Randal Jared Sanders, M.D.
- Surgery Physician
- Greenville, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- LL33800
- Practice address
- 701 Grove Rd
Greenville, SC 29605-5611 - Phone
- (864) 455-7886
- NPI assigned
- Mar 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | LL33800 | SC | Primary |
Addresses
Primary practice location
701 Grove Rd
Greenville, SC 29605-5611
Mailing address
701 Grove Rd
Greenville, SC 29605-5611
Phone (864) 455-7886
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Mercer University School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2409 N Patterson St
Suite 200
Valdosta, GA 31602-2512
Phone (229) 333-1711
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair - groin (open) | 15 |
| Hernia repair (minimally invasive) | 1-10 |
| Mastectomy | 31 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 13 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL33800 | SC | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SGMC Affiliated Services LLC | Current | Accepting new patients | |
| SGMC Physician Network Inc | Surgery | Current | Accepting new patients |
| South Georgia Medical Center Inc | Past | Accepting new patients |
Locations
4280 N Valdosta Rd
Valdosta, GA 31602
Phone (229) 433-7350
2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139
2330 N Ashley St
Valdosta, GA 31602
Phone (229) 249-5080
Interoperability endpoints
- rsanders7101@sgmc.gadirect.net
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Valdosta, GA
- NPI 1114740362
-
- General Acute Care Hospital
- Valdosta, GA
- NPI 1144096553
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Valdosta, GA
- NPI 1144096553
-
- General Acute Care Hospital
- Nashville, GA
- NPI 1689440091
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340841600000",
"number": "1780983478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 GROVE RD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296055611",
"telephone_number": "864-455-7886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 GROVE RD",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296055611",
"telephone_number": "864-455-7886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "RANDAL",
"middle_name": "JARED",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-03-21",
"last_updated": "2012-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SC",
"license": "LL33800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.