Individual provider Active NPI

Monica Lauren Sanders, D.C.

  • Chiropractor
  • St. Simons Island, GA
National Provider Identifier
1982902698
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO08780 Issued in GA
Practice address
302 Redfern Village
St. Simons Island, GA 31522-2537
Phone
(912) 268-4277
Fax
(912) 268-4289
NPI assigned
Mar 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO08780 GA Primary

Addresses

Primary practice location

302 Redfern Village
St. Simons Island, GA 31522-2537

Mailing address

302 Redfern Village
St. Simons Island, GA 31522-2537
Phone (912) 268-4277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110405000164 GA Practitioner - Chiropractic 9537343256 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIRO08780GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Chiropractic Palms PC Chiropractor CurrentSince Apr 20, 2012 Accepting new patients
Script Source Pharmacy, LLC PastSince Dec 3, 2012 Accepting new patients
Elite Health Innovations LLC Chiropractor PastSince Oct 18, 2024 Accepting new patients
South Georgia Chiropractic Chiropractor Past Accepting new patients

Locations

102 Redfern Vlg
St Simons Island, GA 31522
Phone (912) 268-4277

302 Redfern Vlg
St Simons Island, GA 31522
Phone (912) 268-4277

Organizations & group practices 4

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": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1982902698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 REDFERN VILLAGE",
            "city": "ST. SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222537",
            "telephone_number": "912-268-4277",
            "fax_number": "912-268-4289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 REDFERN VILLAGE",
            "city": "ST. SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222537",
            "telephone_number": "912-268-4277",
            "fax_number": "912-268-4289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MONICA",
        "middle_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-03",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO08780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Simons Island, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.