Sanctus

Primary specialty

SpecialistTaxonomy code 174400000X

License

0019002389 Issued in VA

Legal business name

SANCTUS

Practice address

1372 Old Bridge Rd # 102
Woodbridge, VA 22192-2708

Phone

(703) 966-5526

Fax

(703) 680-9322

NPI assigned

May 11, 2015

Last updated

May 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Carol Syvret Austin, CMT

Title

Owner

Phone

(703) 966-5526

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1184002263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1372 OLD BRIDGE RD # 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922708",
            "telephone_number": "703-966-5526",
            "fax_number": "703-680-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1372 OLD BRIDGE RD # 102",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221922708",
            "telephone_number": "703-966-5526",
            "fax_number": "703-680-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "SYVRET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-966-5526",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CMT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0019002389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; 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.