Active NPI
Clinton Charles Sanford, MD
- Family Medicine Physician
- Silverton, OR
National Provider Identifier
1902977002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 10096
- Practice address
- 333 Fairview St
Silverton, OR 97381-1916 - Phone
- (503) 873-2770
- Fax
- (503) 873-2735
- NPI assigned
- Nov 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 10096 | OR | Primary |
Addresses
Primary practice location
333 Fairview St
Silverton, OR 97381-1916
Mailing address
333 Fairview St.
Silverton, OR 97381
Phone (503) 873-2770
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 232728 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10096 | OR | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280966400000",
"number": "1902977002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 FAIRVIEW ST.",
"city": "SILVERTON",
"state": "OR",
"postal_code": "97381",
"telephone_number": "503-873-2770",
"fax_number": "503-873-2735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 FAIRVIEW ST",
"city": "SILVERTON",
"state": "OR",
"postal_code": "973811916",
"telephone_number": "503-873-2770",
"fax_number": "503-873-2735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANFORD",
"first_name": "CLINTON",
"middle_name": "CHARLES",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-11",
"last_updated": "2010-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "10096",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "232728",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Silverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.