Johnny J Sacco, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

94306 Issued in OK

Practice address

1921 Stonecipher Dr
Ada, OK 74820-3439

Phone

(580) 436-3980

Fax

(580) 421-6283

NPI assigned

Feb 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL, TX2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chickasaw Nation Division of Health Chickasaw Nation Medical CenterGroup PAC ID 8426957523, 243 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jsacco22890@direct.chickasawnationhealth.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chickasaw Nation Division of Health

  dba Chickasaw Nation Medical Center

  • General Acute Care Hospital
  • Ada, OK
  • NPI 1255364923

  TX

  Medicare reassignment Care Compare group NPD
• Providence Hospital

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1952390643
  Medicare reassignment NPD
• Chickasaw Nation Division of Health

  dba Chickasaw Nation Tishomingo Clinic

  • Primary Care Clinic/Center
  • Tishomingo, OK
  • NPI 1649330242
  NPD
• Chickasaw Nation Division of Health Chickasaw Nation Medical Center

  dba Minticha Apila

  • Home Health Agency
  • Ada, OK
  • NPI 1811739071
  NPD
• Providence Hospital

  • Anesthesiology Physician
  • Mobile, AL
  • NPI 1992133912
  NPD
• Jackson County Memorial Hosp Phcy

  dba Jackson County Memorial Hospital Pharmacy

  • Institutional Pharmacy
  • Altus, OK
  • NPI 1518028380
  NPD (past)
• Coastal Anesthesia, P.C.

  • Anesthesiology Physician
  • Mobile, AL
  • NPI 1588637169
  NPD (past)

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1285607838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 WARRIOR WAY",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203491",
            "telephone_number": "580-421-4570",
            "fax_number": "580-421-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 STONECIPHER DR",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203439",
            "telephone_number": "580-436-3980",
            "fax_number": "580-421-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACCO",
        "first_name": "JOHNNY",
        "middle_name": "J",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1079255",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "94306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200227680A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009974030",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glenene Ruth
• Michelle Elaine Rutherford
• Joel Rutledge, LPC, LADC
• Theodore Mark Rutledge, MD
• Trudy N Rutledge, ICADC
• Sarah Elizabeth Sadler
• Saints Medical Group, LLC (Tory Norred, MD)
• Saints Medical Group, LLC (O'Neill Family Practice)
• Cynthia A Sam, MS, APRN
• Katherine Allene Sampson

• Certified Registered Nurse Anesthetist in Ada, OK
• Providers in Ada, OK by specialty
• Certified Registered Nurse Anesthetist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.