Individual provider Active NPI

Sandra Anne Landers, LCSW

  • Clinical Social Worker
  • North Port, FL
National Provider Identifier
1871770701
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 5153 Issued in FL
Practice address
2500 Bobcat Village Center Rd Unit F
North Port, FL 34288-8476
Phone
(954) 676-8860
Fax
(888) 821-8320
NPI assigned
Jan 22, 2008
Last updated
Jul 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW 5153 FL Primary

Addresses

Primary practice location

2500 Bobcat Village Center Rd Unit F
North Port, FL 34288-8476

Mailing address

PO Box 494081
Port Charlotte, FL 33949-4080
Phone (954) 668-7689

Other identifiers 1

IdentifierTypeStateIssuer
Z027POtherFLBLUE CROSS/BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040515000265 FL Practitioner - Clinical Social Worker 5799775300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2500 Bobcat Village Ctr Rd
Unit F
North Port, FL 34288-8476
Phone (954) 676-8860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 5153FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Calm Matters, Inc Clinical CurrentSince Jul 23, 2021 Accepting new patients

Locations

2500 Hollywood Blvd
Ste 409
Hollywood, FL 33020
Phone (954) 668-7689

2500 Bobcat Village Center Rd
Unit F
North Port, FL 34288
Phone (954) 676-8860

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1871770701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 494081",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339494080",
            "telephone_number": "954-668-7689",
            "fax_number": "888-821-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 BOBCAT VILLAGE CENTER RD UNIT F",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342888476",
            "telephone_number": "954-676-8860",
            "fax_number": "888-821-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDERS",
        "first_name": "SANDRA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 5153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "Z027P",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Port, FL

Sources for this page

Verify at the official NPI Registry.