Sanctuary Integrative Medicine PC

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

0420006819 Issued in VT

Legal business name

SANCTUARY INTEGRATIVE MEDICINE PC

Practice address

90 Mahoney Ave
Rutland, VT 05701-4836

Phone

(802) 775-7848

Fax

(802) 774-5145

NPI assigned

Oct 23, 2008

Organization subpart

No

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

Authorized official

Name

Mark E Logan, MD

Title

Provider

Phone

(802) 775-7848

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276819200000",
    "number": "1568615441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 MAHONEY AVE",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014836",
            "telephone_number": "802-775-7848",
            "fax_number": "802-774-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 MAHONEY AVE",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014836",
            "telephone_number": "802-775-7848",
            "fax_number": "802-774-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY INTEGRATIVE MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-23",
        "last_updated": "2010-06-18",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "802-775-7848",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "VT",
            "license": "0420006819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adelaide Jean Salley, LICSW
• Alison R Sanborn, MS, OTR.L
• Carolyn Sanborn, M.S.
• Philip Brendon Alquiza Sanchez, AUD
• Dalite Sancic, L.AC.
• Shawn Stephen Sandels, OTD
• Yohanny Giselle Santana, LMSW
• Samantha Santorello, PHARMD
• Sarah Greenspan Therapy
• Thomas Henry Sarault

• Public Health & General Preventive Medicine Physician in Rutland, VT
• Providers in Rutland, VT by specialty
• Public Health & General Preventive Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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.