Shelley Sanderson, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

267385-4405 Issued in UT

Practice address

223 South 200 East
Enterprise, UT 84725-0370

Phone

(435) 878-2281

Fax

(435) 878-2434

NPI assigned

Sep 20, 2006

Last updated

Dec 2, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Shelley Reeder Former name

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Dialysis Program Physicians University of Utah

  • Specialist
  • Salt Lake City, UT
  • NPI 1689770356
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1962509786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 SOUTH 200 EAST STREET",
            "city": "ENTERPRISE",
            "state": "UT",
            "postal_code": "847250370",
            "telephone_number": "435-878-2281",
            "fax_number": "435-878-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 SOUTH 200 EAST",
            "city": "ENTERPRISE",
            "state": "UT",
            "postal_code": "847250370",
            "telephone_number": "435-878-2281",
            "fax_number": "435-878-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "SHELLEY",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "267385-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELLEY",
            "last_name": "REEDER",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• KTM Health Care Inc (Enterprise Valley Pharmacy)
• KTM Health Care Inc (Enterprise Valley Closed)
• Main Street Family Medicine PLLC
• Jackie Neilson
• Emily Preston, CLD
• Stapley Pharmacy, Inc. (Stapley Pharmacy Enterprise)
• Ryan Steadman
• Karl Torgerson, P.A.
• Truman & Moore Therapy (Enterprise Valley Physical Therapy)
• Lonnie J Truman, PT

• Nurse Practitioner in Enterprise, UT
• Providers in Enterprise, UT by specialty
• Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.