Individual provider Active NPI

Sandra M Herder, APRN

  • Nurse Practitioner
  • Dodge City, KS
National Provider Identifier
1982855565
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
53-44816 Issued in KS
Practice address
100 Ross Blvd Suite 2a
Dodge City, KS 67801
Phone
(620) 227-3141
Fax
(620) 227-8095
NPI assigned
Oct 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1474105061 KS
Nurse Practitioner 363L00000X 53-44816 KS Primary

Addresses

Primary practice location

100 Ross Blvd Suite 2a
Dodge City, KS 67801

Mailing address

100 Ross Blvd Suite 2a
Dodge City, KS 67801
Phone (620) 227-3141

Other identifiers 1

IdentifierTypeStateIssuer
111190002OtherKSMEDICARE PTAN

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
53-44816KSMDNurse Practitioner
1474105061KSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dan a Francisco MD PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sandra.herder.p1@direct.dafvmed.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1982855565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ROSS BLVD SUITE 2A",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "67801",
            "telephone_number": "620-227-3141",
            "fax_number": "620-227-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ROSS BLVD SUITE 2A",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "67801",
            "telephone_number": "620-227-3141",
            "fax_number": "620-227-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERDER",
        "first_name": "SANDRA",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "1474105061",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-44816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "111190002",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.