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KENNETH WAYNE SANDERS MD
NPI 1427080043
Otolaryngology - Plastic Surgery within the Head & Neck in Shreveport, LA

Active since July 06, 2006PECOS Enrolled
8711 LINE AVE, SHREVEPORT, LA 71106(318) 698-8711(318) 988-6766 Get Directions Write a Review

NPPES record last updated: September 30, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 30, 2019, Sep 20, 2019 (2 updates tracked since 2019).

About Kenneth Wayne Sanders Md NPPES

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

KENNETH WAYNE SANDERS MD (NPI 1427080043) is an individual plastic surgery within the head & neck provider in Shreveport, Louisiana, licensed in Louisiana (022757) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1427080043
Entity TypeIndividualMale
Primary Taxonomy207YX0007X
Provider Legal NameKENNETH WAYNE SANDERSCredential: MD
Location Address8711 LINE AVEShreveport, LA 71106-6813
Mailing Address1811 E Bert Kouns Industrial Loop, Suite 160Shreveport, LA 71105-5740 · (318) 212-3223 · Fax (318) 212-3989
Phone(318) 698-8711
Fax(318) 988-6766
Sole ProprietorYes
Enumeration DateJuly 6, 2006
Last NPPES UpdateSeptember 30, 20192 updates tracked since enumeration
✔ NPI 1427080043 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngology · Plastic Surgery within the Head & NeckAllopathic & Osteopathic Physicians
Taxonomy Code207YX0007X
License✔ Licensed in LA · 022757
Definition
An otolaryngologist with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgeries are practiced, there are many additional procedures which interface with them.
8711 LINE AVE, Shreveport, LA 71106
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Other Identifiers 1

Medicaid1686735LA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth Wayne Sanders Md 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.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SLSC MEDICAL STAFF
Clinic/Center (Ambulatory Surgical)
8711 LINE AVE
SHREVEPORT, LA 71106
Caddo Parish (318) 841-4486

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 Kenneth Sanders's NPI number?

The NPI number for Kenneth Sanders is 1427080043. It was assigned to this individual provider in the NPPES registry on July 6, 2006.

Where is Kenneth Sanders located?

Kenneth Sanders practices at 8711 Line Ave, Shreveport, LA 71106. The listed phone number is (318) 698-8711.

What is Kenneth Sanders's specialty?

The primary specialty registered for this NPI is Otolaryngology, specializing in Plastic Surgery within the Head & Neck, with taxonomy code 207YX0007X.

Is Kenneth Sanders enrolled in Medicare?

Yes. Kenneth Sanders is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kenneth Sanders was last updated on September 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.