SCOUT SANDERS – Clinical Social Worker, NPI 1093575508

SCOUT SANDERS is a healthcare provider. based in Flora, Illinois. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 149026492 (IL). The NPI Number for SCOUT SANDERS is 1093575508

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
SCOUT SANDERS
NPI
1093575508
Phone
Not provided
Address
708 SHADWELL AVE
Enumeration Date
21 March 2024
Last Update Date
21 March 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6186622131
Graduation Year
2021 (5 years ago)
PAC ID
4284075292
Group Practice PAC ID
0042101982
Professional Enrollment ID
I20240508001846
Address ID
IL628581053LO935XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

3,510 CLINICAL SOCIAL WORKER in IL

Provider Addresses for SCOUT SANDERS

  • 708 SHADWELL AVE

    FLORA, IL 628392309

    Phone:

    Type: Mailing

  • 929 STACEY BURK DR

    FLORA, IL 628393241

    Phone: (618) 662-2131

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240508001846IClinical Social WorkerILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 62839)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042101982View full group profile
NameSpecialtyState
Nurse PractitionerIL
Clinical Social WorkerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)MO
Family PracticeIL
General SurgeryIL
Nurse PractitionerIL
Diagnostic RadiologyFL

Reviews

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Frequently asked questions

How do payers reference SCOUT SANDERS?
For SCOUT SANDERS, use NPI 1093575508 as the unique 10-digit identifier.
Would SCOUT SANDERS appear as active to a payer?
You can treat SCOUT SANDERS as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is SCOUT SANDERS?
SCOUT SANDERS is associated with Clinical Social Worker in the directory — Clinical services aligned with this taxonomy classification.
Where in Illinois is SCOUT SANDERS registered?
Use Flora, Illinois as the headline location for SCOUT SANDERS here.
When was this NPI issued?
Enumeration for SCOUT SANDERS is noted as March 21, 2024 where the registry provides it.

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