Active NPI
Sara Christine Sackett, RDN
- Registered Dietitian
- Salem, OR
National Provider Identifier
1124691928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Practice address
- 4163 Sunray Ave S.
Salem, OR 97302 - Phone
- (619) 372-9799
- NPI assigned
- Jul 20, 2021
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | OR | Primary | |
| Renal Nutrition Registered Dietitian | 133VN1005X | |||
| Gerontological Nutrition Registered Dietitian | 133VN1101X | |||
| Obesity and Weight Management Nutrition Registered Dietitian | 133VN1201X | |||
| Sports Dietetics Nutrition Registered Dietitian | 133VN1501X |
Addresses
Primary practice location
4163 Sunray Ave S.
Salem, OR 97302
Mailing address
4163 Sunray Ave S.
Salem, OR 97302
Phone (619) 372-9799
Other names 1
- Sara Christine Shirvani
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705968000000",
"number": "1124691928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4163 SUNRAY AVE S.",
"city": "SALEM",
"state": "OR",
"postal_code": "97302",
"telephone_number": "619-372-9799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4163 SUNRAY AVE S.",
"city": "SALEM",
"state": "OR",
"postal_code": "97302",
"telephone_number": "619-372-9799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACKETT",
"first_name": "SARA",
"middle_name": "CHRISTINE",
"name_prefix": "Mrs.",
"credential": "RDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-20",
"last_updated": "2024-01-23",
"certification_date": "2024-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OR",
"license": null,
"primary": true
},
{
"code": "133VN1005X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Renal",
"state": null,
"license": null,
"primary": false
},
{
"code": "133VN1101X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Gerontological",
"state": null,
"license": null,
"primary": false
},
{
"code": "133VN1201X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "133VN1501X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SARA",
"last_name": "SHIRVANI",
"middle_name": "CHRISTINE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.