Individual provider Active NPI

Desmond Kneib Sanderson Jr., FNP-C

  • Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1861862286
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
26NJ00613800 Issued in NJ
Practice address
7032 Emlen Street
Philadelphia, PA 19149-3603
Phone
(215) 409-8466
NPI assigned
Sep 28, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 26NJ00613800 NJ Primary

Addresses

Primary practice location

7032 Emlen Street
Philadelphia, PA 19149-3603

Mailing address

7032 Emlen Street
Philadelphia, PA 19149-3603
Phone (215) 409-8466

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dsanderson19275@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160119000837 PA Practitioner - Nurse Practitioner 3577866953
I20160504002500 NJ Practitioner - Nurse Practitioner 3577866953 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-3328

Hospital & facility affiliations

  • Virtua Our Lady of Lourdes Hospital Hospital, Camden, NJ, CCN 310029
  • West Jersey Hospital Hospital, Voorhees, NJ, CCN 310022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00613800NJMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Multi-Specialty CurrentSince Mar 20, 2016 Accepting new patients
Atlanticare Regional Medical Center Multi-Specialty CurrentSince Aug 15, 2025 Accepting new patients
Advocare , LLC Multi-Specialty CurrentSince Mar 20, 2016 Accepting new patients
Atlanticare Regional Medical Center CurrentSince Aug 15, 2025 Accepting new patients
Virtua Medical Group, PA Multi-Specialty CurrentSince Mar 20, 2016 Accepting new patients
Advocare, LLC Multi-Specialty CurrentSince Mar 20, 2016 Accepting new patients
Atlanticare Physician Group Multi-Specialty CurrentSince Jun 28, 2020 Accepting new patients
Atlanticare Physician Group, PA CurrentSince Jun 28, 2020 Accepting new patients
Atlanticare Physician Group PA Multi-Specialty Current Accepting new patients

Locations

1925 Pacific Ave
Atlantic City, NJ 08401
Phone (609) 441-8023

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

459 Route 9 S
Little Egg Harbor Twp, NJ 08087
Phone (609) 340-7815

90 Brick Rd
Fl 3
Marlton, NJ 08053
Phone (856) 247-2160

65 W Jimmie Leeds Rd
Pomona, NJ 08240
Phone (609) 484-6414

100 Bowman Dr
Fl 1
Voorhees, NJ 08043
Phone (856) 247-2645

Interoperability endpoints

  • Direct secure messaging: dsanderson19275@directvirtua.org

Organizations & group practices 9

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": "1443398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1861862286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7032 EMLEN STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191493603",
            "telephone_number": "215-409-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7032 EMLEN STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191493603",
            "telephone_number": "215-409-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "DESMOND",
        "middle_name": "KNEIB",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-28",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00613800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsanderson19275@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Fl 1",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.