Sandra June Northway
Nurse Practitioner (Family)

Address: 1326 Fl-100 Melrose, Fl 32666, Melrose, FL 32666
Phone: 3866592104

Sandra June Northway (NPI# 1487166021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1487166021
Entity Type Individual
Full Name Sandra June Northway
Credential ARNP
Gender Female
Practice Address 1326 Fl-100 Melrose, Fl 32666
Melrose
FL 32666
Practice Telephone 3866592104
Mailing Address 4406 Station Fwy
Keystone Heights
FL 32656-6702
Mailing Telephone 3522621980
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2017-11-03
Last Update Date 2018-06-16

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363LF0000X Nurse Practitioner · Family Physician Assistants & Advanced Practice Nursing Providers 9200321 FL

Physician Overview

NPI 1487166021
PAC ID by PECOS 7416219225
Professional Enrollment ID I20180314001864
Full Name Sandra J Northway
Organization Legal Name STARKE FAMILY MEDICAL CENTER INC
Phone Number 3524733199
Gender F
Graduation Year 2017
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 0143207704
Number of Group Practice Members 8
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
100321 ST VINCENTS MEDICAL CENTER - CLAY COUNTY
101310 SHANDS STARKE REGIONAL MEDICAL CENTER
100232 PUTNAM COMMUNITY MEDICAL CENTER

Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to comeā€¦

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1396274445 Mary A Tompkins Nurse Practitioner 153 Skyline Dr, Melrose, NY 12121-1922 2017-06-11
1831230564 Delcora Howell Nurse Practitioner 1745 State Road 100, Melrose, FL 32666-3146 2007-02-08
1376536854 Edna Gail Gutierrez Nurse Practitioner 121 N. Main, Melrose, NM 88124 2005-08-30
1306456256 Jill Marie Wilcken Nurse Practitioner 525 Main St W, Melrose, MN 56352-1043 2020-08-05
1871118604 Heart 2 Heart Family Practice Nurse Practitioner 1326 State Road 100, Melrose, FL 32666-3701 2020-06-08
1952955320 Joshua Larson Nurse Practitioner 525 Main St W, Melrose, MN 56352-1043 2019-07-24
1346727211 Jennifer Rose Tomford Nurse Practitioner 525 Main St W, Melrose, MN 56352-1043 2018-07-24
1720565617 Elaine Mary Thelen Nurse Practitioner 525 Main St W, Melrose, MN 56352-1043 2018-07-24
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Office Location

Street Address 1326 FL-100 MELROSE, FL 32666
City MELROSE
State FL
Zip Code 32666

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477932408 Eswt Inc Specialist 671 Se 5th Avenue, Box 91, Melrose, FL 32666 2015-05-22
1770722936 Medical and Wellness Center of Melrose Corporation Family Medicine 1745 Sr 100, Melrose, FL 32666 2009-02-11
1598987786 Jeffrey C Smith Dentist 100 S R 26, Melrose, FL 32666 2007-05-03
1558491555 Elisa Neale-tobener Speech-Language Pathologist 861 Hwy 21, Melrose, FL 32666 2007-03-07
1649280785 Laura S Hodges Physical Therapist 25727 Ne Sr 26, Melrose, FL 32666 2006-08-09
1376682518 Lake Area Physical Therapy Inc Physical Therapist 25727 Ne State Rd 26, Melrose, FL 32666-1099 2007-02-05
1417150905 Richard C Sturdivant Specialist 123 1st St, Melrose, FL 32666-3030 2007-06-11
1194104414 Anne Wister Specialist 102 Serenity Dr, Melrose, FL 32666-3032 2015-05-19
1609033646 Canaide Inc Supports Brokerage 723 State Road 26, Melrose, FL 32666-3139 2008-05-19
1831230564 Delcora Howell Nurse Practitioner 1745 State Road 100, Melrose, FL 32666-3146 2007-02-08
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Competitor

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City MELROSE
Zip Code 32666

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.