Active NPI
Gregory R Sacho, OD
- Optometrist
- Columbia, IL
National Provider Identifier
1588754758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046006642
- Practice address
- 108 S Main St
Columbia, IL 62236-2306 - Phone
- (618) 281-4500
- Fax
- (618) 281-4595
- NPI assigned
- Oct 16, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046006642 | IL | Primary |
| Optometrist | 152W00000X | T02381 | MO |
Addresses
Primary practice location
108 S Main St
Columbia, IL 62236-2306
Mailing address
12386 Topsfield CT
Creve Coeur, MO 63141
Phone (314) 628-9009
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046006642 | IL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295481600000",
"number": "1588754758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12386 TOPSFIELD CT",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "63141",
"telephone_number": "314-628-9009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 S MAIN ST",
"city": "COLUMBIA",
"state": "IL",
"postal_code": "622362306",
"telephone_number": "618-281-4500",
"fax_number": "618-281-4595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACHO",
"first_name": "GREGORY",
"middle_name": "R",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2011-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046006642",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "T02381",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.