Active NPI
Kristina B Sacks
- Pharmacist
- Scottsdale, AZ
National Provider Identifier
1104112960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S016418
- Practice address
- 15444 N Frank Lloyd Wright Blvd
Target Pharmacy 936
Scottsdale, AZ 85260-2845 - Phone
- (480) 860-0219
- Fax
- (480) 860-0219
- NPI assigned
- Jun 21, 2011
- Last updated
- Jun 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | S016418 | AZ | Primary |
Addresses
Primary practice location
15444 N Frank Lloyd Wright Blvd
Target Pharmacy 936
Scottsdale, AZ 85260-2845
Mailing address
15444 N. Frank Lloyd Wright Blvd.
Target Pharmacy 936
Scottsdale, AZ 85260
Phone (480) 860-0219
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S016418 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Carolina CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308614400000",
"number": "1104112960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15444 N. FRANK LLOYD WRIGHT BLVD.",
"address_2": "TARGET PHARMACY 936",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "85260",
"telephone_number": "480-860-0219",
"fax_number": "480-860-0219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15444 N FRANK LLOYD WRIGHT BLVD",
"address_2": "TARGET PHARMACY 936",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852602845",
"telephone_number": "480-860-0219",
"fax_number": "480-860-0219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACKS",
"first_name": "KRISTINA",
"middle_name": "B",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-21",
"last_updated": "2011-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S016418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.