Justin Karl Sacco

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

140 S Holly St
Medford, OR 97501-3113

Phone

(541) 734-3902

NPI assigned

Jun 26, 2020

Last updated

Jun 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1508483405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 W HERSEY ST",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975201158",
            "telephone_number": "541-879-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S HOLLY ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013113",
            "telephone_number": "541-734-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACCO",
        "first_name": "JUSTIN",
        "middle_name": "KARL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-26",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Celeste Ryane, LCSW
• Anne Ryland, PA
• B Christine S Hollingsworth, RNFA
• Leah Sabel
• Terica R. Sabin, PTA
• Pawani Sachar, M.D.
• Karen Sachitano, RN, BSN
• Shelby Joy Sackett, PA-C
• Sacred Temple Healing
• Marlene Sadler

• Peer Specialist in Medford, OR
• Providers in Medford, OR by specialty
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.