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Sandisover Annettie Grant , APRN

Nurse Practitioner β€’ Orange Park, FL

Active NPI 1962339440 Individual Practitioner Female Practitioner
Practice location in NPPES

1465 Kingsley Ave
Orange Park, FL 320734504

Call 9046440092 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1465 Kingsley Ave

Orange Park, FL 320734504

Telephone 9046440092
Organization at the Same NPPES Address or Phone
Southeast Outpatient Consultants Llc Facility NPI 1023450012

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Jacksonville, FL. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2021–2025.

Guide: How to read an Open Payments record

NPI first issued

2026

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Sandisover Grant has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Sandisover Grant as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Orange Park and Florida

39 active clinicians are listed under Nurse Practitioner with a practice address in Orange Park, FL (8,853 in Florida).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Orange Park

12.8% of these 39 clinicians have the CMS telehealth indicator.

53.8% of these 39 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-06-05
Nurse Practitioner Primary Specialty

NUCC Taxonomy Code: 363L00000X

License # reported to NPPES FL 11044607

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Florida Department of Health Medical Quality Assurance.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - NURSE PRACTITIONER

Medicare Enrollment ID

I20260615004033

Enrollment State Jurisdiction

FL

PECOS Control ID

4981176591

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

7011 A C Skinner Pkwy Ste 160

Jacksonville, FL 322566953

Phone: 9046440092

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

7 listed
Dr. Youssef Al-Saghir , MD

Internal Medicine - Interventional Cardiology

NPI 1871600783

Doctor of Medicine (M.D.)

Dr. Firas El Sabbagh , MD

Internal Medicine - Clinical Cardiac Electrophysiology

NPI 1871793604

Doctor of Medicine (M.D.)

Dr. Ibrahim Fahdi , MD

Internal Medicine - Cardiovascular Disease

NPI 1588754055

Doctor of Medicine (M.D.)

Dr. Yuhning Hu , MD

Internal Medicine - Clinical Cardiac Electrophysiology

NPI 1457515314

Doctor of Medicine (M.D.)

Charlotte Mack , APRN

Nurse Practitioner - Family

NPI 1194367383

Advanced Practice Registered Nurse

Lindsay Richmond , APRN

Nurse Practitioner

NPI 1366187791

Advanced Practice Registered Nurse

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸ“
Updated Business Mailing Address June 05, 2026

Registered at PO BOX 919932, ORLANDO, FL 328919932 (Tel: 9044933333)

βœ…
NPI Profile Active May 07, 2026

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) May 07, 2026

Registered at 1465 KINGSLEY AVE, ORANGE PARK, FL 320734504 (Tel: 9046440092)

πŸ“
Business Mailing Address (Initial Record) May 07, 2026

Registered at 3140 RIDGEVIEW DRIVE, GREEN COVE SPRINGS, FL 32043 (Tel: 7576095277)

πŸ‘€
Provider Name / Credentials (Initial Record) May 07, 2026

Recorded as SANDISOVER GRANT, APRN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 07, 2026

Nurse Practitioner (license number reported to NPPES: FL 11044607)

🟒
Initial NPI Registration & Enumeration May 07, 2026

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1962339440
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 07, 2026
Last Update: June 05, 2026
Sole Proprietor: No

Other Nurse Practitioners in Orange Park

All Nurse Practitioners in Orange Park

Mailing Address

Po Box 919932

Orlando, FL 328919932

Phone: 9044933333

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.