DR. KEVIN PAUL SANU MD
NPI 1710675715
Student in an Organized Health Care Education/Training Program in Dalton, GA

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since April 27, 2023PECOS Enrolled

1432 BROADRICK DRIVE, DALTON, GA 30720(706) 226-8990(706) 529-5317 Get Directions Write a Review

NPPES record last updated: October 9, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 9, 2024, Aug 9, 2023 (2 updates tracked since 2023).

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About Dr. Kevin Paul Sanu Md NPPES

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

DR. KEVIN PAUL SANU MD (NPI 1710675715) is an individual student in an organized health care education/training program in Dalton, Georgia, licensed in Georgia (15058) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1710675715

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameDR. KEVIN PAUL SANUCredential: MD

Location Address1432 BROADRICK DRIVEDalton, GA 30720

Mailing Address1200 Memorial DriveDalton, GA 30720 · (706) 226-8996 · Fax (706) 272-6761

Phone(706) 226-8990

Fax(706) 529-5317

Sole ProprietorNo

Enumeration DateApril 27, 2023

Last NPPES UpdateOctober 9, 20242 updates tracked since enumeration

NPPES CertifiedApril 27, 2023

✔ NPI 1710675715 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

License✔ Licensed in GA · 15058

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1432 BROADRICK DRIVE, Dalton, GA 30720

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kevin Paul Sanu 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 20

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

DR. SPENCER CARLTON MISNER DPM

Podiatrist

1432 BROADRICK DRIVE, DALTON FOOT AND ANKLE SURGERY CENTER
DALTON, GA 30720

Whitfield County (706) 226-1130

DALTON FOOT & ANKLE CENTER INC

Clinic/Center (Podiatric)