Ellen Louise Sakornbut, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34687 Issued in IA

Practice address

220 W Ridgeway Ave
Suite 106
Waterloo, IA 50701-4200

Phone

(319) 226-4400

Fax

(319) 226-4401

NPI assigned

Jun 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Family Health Center of Waterloo, P.C.

  • Family Medicine Physician
  • Waterloo, IA
  • NPI 1003013731
  NPD (past) Authorized official

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1578567947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W RIDGEWAY AVE",
            "address_2": "SUITE 106",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014200",
            "telephone_number": "319-226-4400",
            "fax_number": "319-226-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W RIDGEWAY AVE",
            "address_2": "SUITE 106",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014200",
            "telephone_number": "319-226-4400",
            "fax_number": "319-226-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKORNBUT",
        "first_name": "ELLEN",
        "middle_name": "LOUISE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "34687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1268821",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK (BC/BS)",
            "identifier": "38764",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Punit Singh Sachdev, M.D
• Helen M Sadler, ARNP
• Karen Marie Sadler, ARNP
• Rodrigue Gninaze Sagbo, PA
• CHI-Ying Diana Sage, ARNP
• Victor Raul Salamanca, M.D.
• Aaron M Salandro
• Roberto Andres Salas Fragomeni, M.D.
• Irmela Salihovic, FNP-C
• Barbara L Salisbury, ARNP

• Family Medicine Physician in Waterloo, IA
• Providers in Waterloo, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.