Individual provider Active NPI

Evelyn Louise Sacko, LVN

  • Licensed Vocational Nurse
  • San Antonio, TX
National Provider Identifier
1417779174
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
200317 Issued in TX
Practice address
9939 SH 151
San Antonio, TX 78251-1900
Phone
(210) 706-7800
NPI assigned
Oct 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 200317 TX Primary

Addresses

Primary practice location

9939 SH 151
San Antonio, TX 78251-1900

Mailing address

9939 SH 151
San Antonio, TX 78251-1900
Phone (210) 706-7800

Other names 1

  • Evelyn Louise McCrimmon Former name

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

LicenseStateTypeSpecialty
200317TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1417779174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9939 SH 151",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511900",
            "telephone_number": "210-706-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9939 SH 151",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511900",
            "telephone_number": "210-706-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACKO",
        "first_name": "EVELYN",
        "middle_name": "LOUISE",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "200317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVELYN",
            "last_name": "MCCRIMMON",
            "middle_name": "LOUISE",
            "credential": "LVN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.

Verify at the official NPI Registry.