Individual provider Active NPI

Thomas Clifton Sanders

  • Physician Assistant
  • Ashland, KY
National Provider Identifier
1821839051
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2201 Lexington Ave
Ashland, KY 41101-2843
Phone
(859) 323-1100
NPI assigned
Jun 3, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2201 Lexington Ave
Ashland, KY 41101-2843

Mailing address

2201 Lexington Ave
Ashland, KY 41101-2843
Phone (859) 323-1100

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250407000981 KY Practitioner - Physician Assistant 5991229403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bourbon Physician Practice LLCGroup PAC ID 8729226097, 11 clinicians

Practice addresses (Care Compare)

1210 Ky Hwy 36 E
Cynthiana, KY 41031-7490
Phone (859) 340-1377

18 Clinic Dr
Paris, KY 40361-2161
Phone (859) 987-5013

22 Clinic Dr
Paris, KY 40361-2161
Phone (859) 987-0074

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
TC026KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bourbon Physician Practice LLC Physician Assistant CurrentSince Mar 30, 2025 Accepting new patients
Bourbon Physician Practice LLC CurrentSince Mar 30, 2025 Accepting new patients

Locations

1210 KY Highway 36 E
Cynthiana, KY 41031
Phone (859) 234-2300

22 Clinic Dr
Paris, KY 40361
Phone (859) 987-0074

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: thomas.sanders.1@19475.direct.athenahealth.com

Organizations & group practices 2

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 1

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": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1821839051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 LEXINGTON AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012843",
            "telephone_number": "859-323-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 LEXINGTON AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012843",
            "telephone_number": "859-323-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "THOMAS",
        "middle_name": "CLIFTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-03",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.