JUSTIN K SANDEFUR (NPI# 1497222400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497222400 |
| Entity Type | Individual |
| Full Name | JUSTIN K SANDEFUR |
| Practice Address |
4900 Mueller Blvd Austin TX 78723-3079 |
| Mailing Address |
4624 Page St Austin TX 78723-5484 |
| Practice Telephone | 5123240515 |
| Mailing Telephone | 5127485404 |
| Enumeration Date | 2018-10-28 |
| Last Update Date | 2018-10-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
AP139467 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
4900 MUELLER BLVD |
| City | AUSTIN |
| State | TX |
| Zip Code | 78723-3079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932102175 | Cathleen M. Havemann | Pediatrics | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2005-05-23 |
| 1235744418 | Ana F. El Behadli Gonzalez | Psychologist | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2020-09-14 |
| 1205449469 | Audrey Cortesi | Psychologist | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2020-08-27 |
| 1134746902 | Catherine Dusing | Student in an Organized Health Care Education/Training Program | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2020-06-28 |
| 1003433863 | Kaitlyn Mosher | Student in an Organized Health Care Education/Training Program | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2020-06-28 |
| 1558980656 | Devika Pillay | Pediatrics | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2020-04-09 |
| 1801429550 | Ashley Griffin | Nurse Practitioner | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2020-02-20 |
| 1770123093 | Anika Lockhart | Nurse Practitioner | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2020-01-14 |
| 1417594102 | Rebecca J Blackwell | Nurse Practitioner | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2019-12-02 |
| 1861037038 | Rachel Annette Cano Brendlinger | Nurse Practitioner | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2019-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144787318 | Bridget Wilson | Counselor | 6448 East Hwy 290, Suite F108, Austin, TX 78723 | 2019-02-25 |
| 1700378999 | Andrew Christopher Shanks | Counselor | 2132 Antone St, Austin, TX 78723 | 2018-06-04 |
| 1316434236 | Yasaman Ahmadieh | Pediatrics | 4900 Mueller Boulevard, Suite 3s.066c, Austin, TX 78723 | 2018-04-16 |
| 1215433354 | Erika Senai Ramirez | Nurse Practitioner | 6900 Ed Bluestein Blvd, Austin, TX 78723 | 2018-04-05 |
| 1518477645 | Brigitte Tyree | Registered Nurse | 2237 Zach Scott St, Austin, TX 78723 | 2017-10-03 |
| 1942735980 | Ila Sehgal | Pediatrics | 4900 Mueller Blvd, Ste 3s.066c, Dell Children's Medical Center, Austin, TX 78723 | 2017-04-27 |
| 1851825194 | Terry Blackmon | Behavioral Analyst | 2021 Zach Scott St, Austin, TX 78723 | 2017-04-13 |
| 1114337961 | Cassandra Sorensen | Home Health | 3001 Maplelawn Circle, Austin, TX 78723 | 2014-05-02 |
| 1336569052 | Ricky C Mehta | Internal Medicine | 6210 E Hwy 290 Ste 420, Austin, TX 78723 | 2014-04-21 |
| 1356761373 | Peter Caldwell Gilbreath | Pediatrics | 4900 Mueller Boulevard, Suite 3s.066c, Dell Children's Medical Center, Austin, TX 78723 | 2014-04-17 |
| Find all providers in zip 78723 | ||||
| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710366893 | Sai Krishna Surapa Raju | Pediatrics | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2015-05-22 |
| 1639513971 | Kelly Bora | Pediatrics | 12221 N Mopac Expy, Austin, TX 78758 | 2013-04-17 |
| 1154603512 | Kyle Scott Miller | Pediatrics | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2011-09-12 |
| 1477849313 | Milton Meadows | Pediatrics | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2011-06-20 |
| 1295038479 | Meghan Lane | Pediatrics | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2010-12-10 |
| 1518019520 | Taj M Khan | Pediatrics | 12221 N Mopac Expy, Austin, TX 78758-2401 | 2007-01-18 |
| 1427138833 | Tandy Alice Mellard | Pediatrics | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2006-10-17 |
| 1073615977 | Kyle Lieppman | Pediatrics | 4900 Mueller Blvd, Austin, TX 78723-3079 | 2006-09-01 |
| 1184731788 | Alexandra Wilson | Pediatrics | 4900 Mueller Blvd, C/o Dell Children's Medical Center, Austin, TX 78723-3079 | 2006-08-23 |
| 1548373079 | Michael Auth | Pediatrics | 4900 Mueller Blvd, C/o Dell Children's Medical Center, Austin, TX 78723-3079 | 2006-08-17 |
| Find all providers in AUSTIN | ||||
Please comment or provide details below to improve the information on JUSTIN K SANDEFUR.
| 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.