Jacob P Sanders, ARNP/DNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

60057 Issued in NM

Practice address

280 1St St
Holloman Afb, NM 88330-8273

Phone

(575) 572-4888

NPI assigned

Mar 5, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Chiro-Med Health and Rehab PL

  • Chiropractor
  • Port Charlotte, FL
  • NPI 1447446828
  NPD (past)

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1821414517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 1ST ST BLDG 23",
            "city": "HOLLOMAN AFB",
            "state": "NM",
            "postal_code": "883308273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 1ST ST",
            "city": "HOLLOMAN AFB",
            "state": "NM",
            "postal_code": "883308273",
            "telephone_number": "575-572-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JACOB",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "ARNP/DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-05",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "60057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrianna Dolores Pranga, PHARMD
• Amy M Railey
• Oscar Ochoa Ramos, LCSW
• Anne Christine Rivera, RD
• Kynna Sanchez
• Jo Ann Schroeder, C.N.P.
• Mayra Serrano
• Shevina Yvette Session, LVN
• Tarek Shabany, D.D.S.
• Kaitlyn M Shaughnessy, DPT

• Adult Health Nurse Practitioner in Holloman Afb, NM
• Providers in Holloman Afb, NM by specialty
• Adult Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.