Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Annie Nicole Sanders , PA-C

Physician Assistant β€’ Kettering, OH

Active NPI 1740068717 Individual Practitioner Female Practitioner Accepts Medicare assignment
Practice location in NPPES

3700 Southern Blvd Ste 201
Kettering, OH 454291265

Call 8555002873 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

3700 Southern Blvd Ste 201

Kettering, OH 454291265

Telephone 8555002873
Fax 9372813805
Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Cape Fear Valley Health Medical Group Llc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

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

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2023

Industry payments (Open Payments)

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

Guide: How to read an Open Payments record

Years since graduation

3 years (graduated 2023)

CMS Doctors and Clinicians data list 2023 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2023

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.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

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)

Annie Sanders 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 Annie Sanders 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 Kettering and Ohio

115 active clinicians are listed under Physician Assistant with a practice address in Kettering, OH (5,329 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Kettering

7.8% of these 115 clinicians have the CMS telehealth indicator.

61.7% of these 115 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: 2026-06-23
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES OH 50.010230RX

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES NY 030688

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES NC 0010-13772

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

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: State Medical Board of Ohio.
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 - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20260508002895

Enrollment State Jurisdiction

OH

PECOS Control ID

5395284129

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.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Cape Fear Valley Health Medical Group Llc

1341 Walter Reed Rd, Fayetteville, NC 283044415

Phone: 9106153500

Clinicians Sharing This Practice Address or Phone

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

38 listed
Dr. Roxana Aguirre Pedroza , MD

Internal Medicine - Hematology & Oncology

NPI 1144537135

Doctor of Medicine (M.D.)

Marryanne Allen , APRN-CNP

Nurse Practitioner - Primary Care

NPI 1528330081

Advanced Practice Registered Nurse - Certified Nurse Practitioner

Carol Amfahr , CNP

Nurse Practitioner - Adult Health

NPI 1245305051

Certified Nurse Practitioner

Julie Broeker , NP

Nurse Practitioner - Family

NPI 1851922181

Nurse Practitioner

Nicole Buckingham , APRN-CNP

Nurse Practitioner - Gerontology

NPI 1053906156

Advanced Practice Registered Nurse - Certified Nurse Practitioner

Dr. Alejandro Calvo , MD

Internal Medicine - Hematology & Oncology

NPI 1457341760

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

12 Historical Events
πŸ“
Updated Practice Location June 23, 2026

Registered at 3700 SOUTHERN BLVD STE 201, KETTERING, OH 454291265 (Tel: 8555002873)

πŸ“
Updated Business Mailing Address June 23, 2026

Registered at 3700 SOUTHERN BLVD STE 201, KETTERING, OH 454291265

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) May 14, 2026

Physician Assistant (license number reported to NPPES: NY 030688)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 03, 2026

Physician Assistant (license number reported to NPPES: NC 0010-13772)

πŸ“
Updated Practice Location November 28, 2023

Registered at 1341 WALTER REED RD, FAYETTEVILLE, NC 283044415 (Tel: 9106153500)

πŸ“
Updated Business Mailing Address November 28, 2023

Registered at 7940 ANCON DR, FAYETTEVILLE, NC 283040407

βœ…
NPI Profile Active September 20, 2023

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) September 20, 2023

Registered at 603 SMILEY AVE, SPRINGDALE, OH 452462221 (Tel: 7653983350)

πŸ“
Business Mailing Address (Initial Record) September 20, 2023

Registered at 603 SMILEY AVE, SPRINGDALE, OH 452462221

πŸ‘€
Provider Name / Credentials (Initial Record) September 20, 2023

Recorded as ANNIE SANDERS, PA-C

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) September 20, 2023

Physician Assistant (license number reported to NPPES: NY 030688)

🟒
Initial NPI Registration & Enumeration September 20, 2023

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1740068717
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 20, 2023
Last Update: June 23, 2026
Sole Proprietor: No

Other Physician Assistants in Kettering

All Physician Assistants in Kettering

Mailing Address

3700 Southern Blvd Ste 201

Kettering, OH 454291265

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.