Organization Active NPI

Sacry Family Medicine PC

  • Primary Care Clinic/Center
  • Carthage, MO
National Provider Identifier
1265684476
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
1999134577 Issued in MO
Legal business name
SACRY FAMILY MEDICINE PC
Practice address
433 S Garrison Ave
Carthage, MO 64836-1749
Phone
(417) 359-8646
NPI assigned
Oct 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Authorized official

Name
Dr. Roger Andrew Sacry, M.D.NPI 1528009529
Title
President
Phone
(417) 388-2746

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 1999134577 MO Primary

Addresses

Primary practice location

433 S Garrison Ave
Carthage, MO 64836-1749

Mailing address

433 S Garrison Ave
Carthage, MO 64836-1749
Phone (417) 359-8646

Other names 1

  • Sacry Family Medicine Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081212000032 MO Part B Supplier - Clinic/Group Practice 0840351649 Receives reassigned benefits from 3 practitioners
Practice locations: Carthage, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D1091724Sacry Family Medicine433 S Garrison Ave, Carthage, MO 64836Certificate of waiverNov 6, 2026

National Provider Directory

National Provider Directory

Locations

211 E Chestnut St
Carthage, MO 64836
Phone (417) 359-8646

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EHJFAA

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1265684476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 S GARRISON AVE",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648361749",
            "telephone_number": "417-359-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 S GARRISON AVE",
            "city": "CARTHAGE",
            "state": "MO",
            "postal_code": "648361749",
            "telephone_number": "417-359-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRY FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "SACRY",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "417-388-2746",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MO",
            "license": "1999134577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacry Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carthage, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.