Individual provider Active NPI

Kurt Sanford, M.D.

  • Gastroenterology Physician
  • Traverse City, MI
National Provider Identifier
1851467641
Registry record updated Aug 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
KS047244 Issued in MI
Practice address
4100 Park Forest Dr
Suite 208
Traverse City, MI 49684-7331
Phone
(231) 935-5710
Fax
(231) 935-9045
NPI assigned
Nov 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X KS047244 MI Primary

Addresses

Primary practice location

4100 Park Forest Dr
Suite 208
Traverse City, MI 49684-7331

Mailing address

4100 Park Forest Dr
Suite 208
Traverse City, MI 49684-7331
Phone (231) 935-5710

Other identifiers 2

IdentifierTypeStateIssuer
OB81010OtherMIBCBSM
4343076MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
KS047244MIMDGastroenterology Physician

NPI Registry JSON

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

{
    "created_epoch": "1164499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219968000000",
    "number": "1851467641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "SUITE 208",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847331",
            "telephone_number": "231-935-5710",
            "fax_number": "231-935-9045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "SUITE 208",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847331",
            "telephone_number": "231-935-5710",
            "fax_number": "231-935-9045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "KURT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-26",
        "last_updated": "2008-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "KS047244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "OB81010",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4343076",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.