Organization Active NPI

Sara Marcino, MD, LLC

  • Psychiatry Physician
  • Charleston, SC
National Provider Identifier
1104032341
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
23890 Issued in SC
Legal business name
SARA MARCINO, MD, LLC
Practice address
1 Carriage LN Ste J
Charleston, SC 29407-6060
Phone
(843) 573-5050
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sara Marcino, M.D.
Title
Owner
Phone
(843) 573-5050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 23890 SC Primary

Addresses

Primary practice location

1 Carriage LN Ste J
Charleston, SC 29407-6060

Mailing address

1 Carriage LN Ste J
Charleston, SC 29407-6060
Phone (843) 573-5050

Other identifiers 1

IdentifierTypeStateIssuer
238905MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104032341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CARRIAGE LN STE J",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076060",
            "telephone_number": "843-573-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CARRIAGE LN STE J",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294076060",
            "telephone_number": "843-573-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARA MARCINO, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARCINO",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-573-5050",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "23890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "238905",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.