Individual provider Active NPI

Craig David Sanders, DO

  • Family Medicine Physician
  • Union, KY
National Provider Identifier
1821059791
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02741 Issued in KY
Practice address
605 Man O War Boulevard
Union, KY 41091-2007
Phone
(859) 578-5333
Fax
(859) 384-0216
NPI assigned
Mar 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02741 KY Primary

Addresses

Primary practice location

605 Man O War Boulevard
Union, KY 41091-2007

Mailing address

605 Man O War Boulevard
Union, KY 41091-2007
Phone (859) 578-5333

Other practice location 1

1974 Walton Nicholson Pike
Independence, KY 41051-7906
Phone (859) 356-6800

Other identifiers 2

IdentifierTypeStateIssuer
64048184MedicaidKY
2131704MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20040303000672 KY Practitioner - Family Practice 0749177780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio University, College of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

300 Barnes Rd
Williamstown, KY 41097-9483
Phone (859) 824-8400

Hospital & facility affiliations

  • St Elizabeth Edgewood Hospital, Edgewood, KY, CCN 180035
  • St Elizabeth Florence Hospital, Florence, KY, CCN 180045

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02741KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Dec 1, 2003 Accepting new patients
Summit Medical Group, Inc Family Medicine CurrentSince Dec 1, 2003 Accepting new patients
Summit Medical Group Inc Family Medicine PastSince Apr 27, 2025 Accepting new patients

Locations

201 Medical Village Dr
Edgewood, KY 41017
Phone (859) 341-2044

8780 US Highway 42
Ste A
Florence, KY 41042
Phone (859) 292-0123

8200 Dixie Hwy
Florence, KY 41042
Phone (859) 212-0494

1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700

1974 Walton Nicholson Pike
Independence, KY 41051
Phone (859) 356-6800

605 Man O War Blvd
Union, KY 41091
Phone (859) 578-5333

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

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.

Hospital & facility affiliations 2

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": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1821059791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 MAN O WAR BOULEVARD",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410912007",
            "telephone_number": "859-578-5333",
            "fax_number": "859-384-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 MAN O WAR BOULEVARD",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410912007",
            "telephone_number": "859-578-5333",
            "fax_number": "859-384-0216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1974 Walton Nicholson Pike",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "KY",
            "postal_code": "410517906",
            "country_code": "US",
            "telephone_number": "859-356-6800",
            "fax_number": "859-363-4073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "CRAIG",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "02741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64048184",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2131704",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, KY

Sources for this page

Verify at the official NPI Registry.