Active NPI
Shaneka Sanders
- Skilled Nursing Facility
- Douglasville, GA
National Provider Identifier
1972271104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Practice address
- 8460 Courthouse SQ E FL 4
Douglasville, GA 30134-4555 - Phone
- (470) 505-7848
- NPI assigned
- Sep 2, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
8460 Courthouse SQ E FL 4
Douglasville, GA 30134-4555
Mailing address
PO Box 723
Douglasville, GA 30133-0723
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CN0028730203 | Other | GA | CN0028730203 |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630540800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630540800000",
"number": "1972271104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 723",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301330723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8460 COURTHOUSE SQ E FL 4",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301344555",
"telephone_number": "470-505-7848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "SHANEKA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-02",
"last_updated": "2021-09-02",
"certification_date": "2021-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CN0028730203",
"identifier": "CN0028730203",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.