NPIMap

Individual provider Active NPI

Laura Ashley Sanford, D.O.

  • Family Medicine Physician
  • Talihina, OK
National Provider Identifier
1932644002
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
6247 Issued in OK
Practice address
205 Dallas Street
Talihina Community Clinic
Talihina, OK 74571
Phone
(918) 567-3636
Fax
(918) 567-3635
NPI assigned
Dec 28, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 6247 OK Primary

Addresses

Primary practice location

205 Dallas Street
Talihina Community Clinic
Talihina, OK 74571

Mailing address

205 Dallas Street
Talihina Community Clinic
Talihina, OK 74571
Phone (918) 567-3636

Other identifiers 1

IdentifierTypeStateIssuer
200470580AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190208000545 TX Practitioner - Family Practice 6305184847 Reassigns benefits to 1 organization
I20211214001831 MS Practitioner - Family Practice 6305184847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oklahoma State University College of Osteopathic Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Exceed Physical Therapy, LLCGroup PAC ID 8123378338, 72 clinicians
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

12261 Hwy 49
Gulfport, MS 39503-2976
Phone (228) 265-7185

1340 Broad Ave
Gulfport, MS 39501-2460

1340 Broad Ave
Gulfport, MS 39501-2465

4603 Hospital St
Pascagoula, MS 39581-5337
Phone (228) 822-6040

Hospital & facility affiliations

  • Deaconess Homecare- Region I Home health agency, Laurel, MS, CCN 257085
  • Mississippi Homecare of Picayune Home health agency, Picayune, MS, CCN 257141
  • Memorial Hospital at Gulfport Hospital, Gulfport, MS, CCN 250019
  • Memorial Hospital Biloxi Hospital, Biloxi, MS, CCN 250007
  • Singing River Gulfport Hospital, Gulfport, MS, CCN 250123

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport CurrentSince Oct 18, 2021 Accepting new patients
Memorial Hospital at Gulfport Family Medicine CurrentSince Oct 18, 2021 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Choctaw Nation of Oklahoma Current Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Dec 18, 2018 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Dec 18, 2018 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

116 Menge Ave
Apt B
Pass Christian, MS 39571

1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981

1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204

410 N M St
Hugo, OK 74743
Phone (580) 326-7561

902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600

1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026

109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100

2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200

1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440

205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636

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 63

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1482883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1932644002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 DALLAS STREET",
            "address_2": "TALIHINA COMMUNITY CLINIC",
            "city": "TALIHINA",
            "state": "OK",
            "postal_code": "74571",
            "telephone_number": "918-567-3636",
            "fax_number": "918-567-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 DALLAS STREET",
            "address_2": "TALIHINA COMMUNITY CLINIC",
            "city": "TALIHINA",
            "state": "OK",
            "postal_code": "74571",
            "telephone_number": "918-567-3636",
            "fax_number": "918-567-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "LAURA",
        "middle_name": "ASHLEY",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-28",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "6247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200470580A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Talihina, OK

Sources for this page

Verify at the official NPI Registry.