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ALEX JONATHAN SANDERSON PAC
NPI 1104854967
Physician Assistant - Medical in Pembroke, NC

Active since June 29, 2006PECOS Enrolled
307 EAST WARDELL DRIVE, PEMBROKE, NC 28372(910) 521-2816(910) 521-3583 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Alex Jonathan Sanderson Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALEX JONATHAN SANDERSON PAC (NPI 1104854967) is an individual medical provider in Pembroke, North Carolina and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104854967
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameALEX JONATHAN SANDERSONCredential: PAC
Location Address307 EAST WARDELL DRIVEPembroke, NC 28372
Mailing Address307 East Wardell DrivePembroke, NC 28372 · (910) 521-2816 · Fax (910) 521-3583
Phone(910) 521-2816
Fax(910) 521-3583
Sole ProprietorNo
Enumeration DateJune 29, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1104854967 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
307 EAST WARDELL DRIVE, Pembroke, NC 28372
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Other Identifiers 5

Medicare ID-Type Unspecified2766674ANC · Maxton Medical Center
Medicare ID-Type Unspecified2766674NC · Julian T Pierce Health Ct
Medicare UPINQ71665NC
Medicare ID-Type Unspecified2766674CNC · Lumberton Health Ctr
Medicare ID-Type Unspecified2766674BNC · South Robeson Med Ctr

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alex Jonathan Sanderson Pac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alex Sanderson's NPI number?

The NPI number for Alex Sanderson is 1104854967. It was assigned to this individual provider in the NPPES registry on June 29, 2006.

Where is Alex Sanderson located?

Alex Sanderson practices at 307 East Wardell Drive, Pembroke, NC 28372. The listed phone number is (910) 521-2816.

What is Alex Sanderson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Alex Sanderson enrolled in Medicare?

Yes. Alex Sanderson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alex Sanderson was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.