Individual provider Active NPI

Christopher Edwin Sanders, PH.D.

  • Clinical Psychologist
  • Omaha, NE
National Provider Identifier
1932387214
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY 20797 Issued in CA
Practice address
6910 Pacific St Ste 320
Omaha, NE 68106-1044
Phone
(831) 402-7610
NPI assigned
Feb 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY 20797 CA Primary
Clinical Psychologist 103TC0700X 927 NE

Addresses

Primary practice location

6910 Pacific St Ste 320
Omaha, NE 68106-1044

Mailing address

501 Lighthouse Ave Apt 11
Monterey, CA 93940-1467
Phone (831) 402-7610

Other practice location 1

222 Forest Ave
Pacific Grove, CA 93950-3319
Phone (800) 652-9604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170420002674 NE Practitioner - Clinical Psychologist 1557647807 Practice locations: Grand Island, NE; Omaha, NE
I20220203001738 CA Practitioner - Clinical Psychologist 1557647807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6910 Pacific St
Suite 320
Omaha, NE 68106-1044
Phone (831) 402-7610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY 20797CAMDClinical Psychologist

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1932387214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LIGHTHOUSE AVE APT 11",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939401467",
            "telephone_number": "831-402-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6910 PACIFIC ST STE 320",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681061044",
            "telephone_number": "831-402-7610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Forest Ave",
            "address_purpose": "LOCATION",
            "city": "Pacific Grove",
            "state": "CA",
            "postal_code": "939503319",
            "country_code": "US",
            "telephone_number": "800-652-9604",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "CHRISTOPHER",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-08",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 20797",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NE",
            "license": "927",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.