NPIMap

Organization Active NPI

Jonathan L Sack, MD, PC

  • Family Medicine Physician
  • Hilton Head, SC
National Provider Identifier
1689639247
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JONATHAN L SACK, MD, PC
Practice address
2 Marshland Rd
Hilton Head, SC 29926-2305
Phone
(843) 842-6357
Fax
(843) 842-6352
NPI assigned
Apr 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Authorized official

Name
Dr. Jonathan L Sack, MDNPI 1194780726
Title
President/Owner
Phone
(843) 842-6357

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X SC Primary

Addresses

Primary practice location

2 Marshland Rd
Hilton Head, SC 29926-2305

Mailing address

2 Marshland Rd
Hilton Head, SC 29926-2305
Phone (843) 842-6357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060329000539 SC Part B Supplier - Clinic/Group Practice 7214945476 Receives reassigned benefits from 5 practitioners
Practice locations: Hilton Head Island, SC

National Provider Directory

National Provider Directory

Locations

2 Marshland Rd
Ste 5
Hilton Head Island, SC 29926
Phone (843) 842-2900

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1689639247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MARSHLAND RD",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299262305",
            "telephone_number": "843-842-6357",
            "fax_number": "843-842-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MARSHLAND RD",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299262305",
            "telephone_number": "843-842-6357",
            "fax_number": "843-842-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN L SACK, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "SACK",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "843-842-6357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.