Individual provider Active NPI

Katherine Denton Sanford, OD

  • Optometrist
  • Memphis, TN
National Provider Identifier
1982697025
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2441 Issued in TN
Practice address
1689 Nonconnah Blvd Ste 120
Memphis, TN 38132-2111
Phone
(901) 523-8990
Fax
(901) 577-7456
NPI assigned
Aug 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2441 TN Primary

Addresses

Primary practice location

1689 Nonconnah Blvd Ste 120
Memphis, TN 38132-2111

Mailing address

1689 Nonconnah Blvd Ste 120
Memphis, TN 38132-2111
Phone (901) 523-8990

Other identifiers 2

IdentifierTypeStateIssuer
3946268MedicaidTN
2441OtherTNOD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1982697025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1689 NONCONNAH BLVD STE 120",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381322111",
            "telephone_number": "901-523-8990",
            "fax_number": "901-522-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1689 NONCONNAH BLVD STE 120",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381322111",
            "telephone_number": "901-523-8990",
            "fax_number": "901-577-7456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "KATHERINE",
        "middle_name": "DENTON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3946268",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OD",
            "identifier": "2441",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.