NPIMap

Organization Active NPI

Sanders Clinic for Women PA

  • Obstetrics & Gynecology Physician
  • Tupelo, MS
National Provider Identifier
1962423046
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
SANDERS CLINIC FOR WOMEN PA
Practice address
1041 S Madison St
Tupelo, MS 38801-6309
Phone
(662) 844-8754
NPI assigned
Jul 22, 2006
Last updated
Aug 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Authorized official

Name
Rhonda Kelly
Title
Office Manager
Phone
(662) 844-6295

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

1041 S Madison St
Tupelo, MS 38801-6309

Mailing address

1041 S Madison St
Tupelo, MS 38801-6309
Phone (662) 844-8754

Other identifiers 1

IdentifierTypeStateIssuer
9011671MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040913001047 MS Part B Supplier - Clinic/Group Practice 9537136254 Receives reassigned benefits from 23 practitioners
Practice locations: Tupelo, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D0316937Sanders Clinic for Women1041 South Madison Street, Tupelo, MS 38801ComplianceDec 14, 2026

National Provider Directory

National Provider Directory

Locations

495 S Gloster St
Ste M2
Tupelo, MS 38801
Phone (662) 844-8754

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13706/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1962423046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016309",
            "telephone_number": "662-844-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 S MADISON ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016309",
            "telephone_number": "662-844-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDERS CLINIC FOR WOMEN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-844-6295"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9011671",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.