Active NPI
James Sackett, D.O
- Family Medicine Physician
- Indianapolis, IN
National Provider Identifier
1588655245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 02001549
- Practice address
- 5486 Yellow Birch Way
Indianapolis, IN 46254-9636 - Phone
- (765) 864-8715
- NPI assigned
- Nov 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 02001549 | IN | Primary |
Addresses
Primary practice location
5486 Yellow Birch Way
Indianapolis, IN 46254-9636
Mailing address
5486 Yellow Birch Way
Indianapolis, IN 46254-9636
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200056540 | Medicaid | IN | |
| P01270907 | Other | IN | RR MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02001549 | IN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426550400000",
"number": "1588655245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5486 YELLOW BIRCH WAY",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462549636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5486 YELLOW BIRCH WAY",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462549636",
"telephone_number": "765-864-8715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACKETT",
"first_name": "JAMES",
"credential": "D.O",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2015-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "02001549",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200056540",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P01270907",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.