Active NPI
Leonard L Sacks, M.D.
- Hospitalist Physician
- Austell, GA
National Provider Identifier
1952362642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 22468
- Practice address
- 3950 Austell Rd # 22
Austell, GA 30106-1121 - Phone
- (770) 732-4022
- Fax
- (770) 732-4023
- NPI assigned
- Mar 31, 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 |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 22468 | GA | Primary |
| Specialist | 174400000X | 022468 | GA |
Addresses
Primary practice location
3950 Austell Rd # 22
Austell, GA 30106-1121
Mailing address
3950 Austell Rd # 22
Austell, GA 30106-1121
Phone (770) 732-4022
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000223561A | Medicaid | GA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lsacks23679@directwellstar.org |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22468 | GA | MD | Pastoral Counselor |
| 022468 | GA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571011200000",
"number": "1952362642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3950 AUSTELL RD # 22",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301061121",
"telephone_number": "770-732-4022",
"fax_number": "770-732-4023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3950 AUSTELL RD # 22",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301061121",
"telephone_number": "770-732-4022",
"fax_number": "770-732-4023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SACKS",
"first_name": "LEONARD",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-31",
"last_updated": "2019-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "GA",
"license": "22468",
"primary": true
},
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "022468",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000223561A",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lsacks23679@directwellstar.org",
"affiliation": "N",
"address_1": "3950 Austell Rd # 22",
"city": "Austell",
"state": "GA",
"country_code": "US",
"postal_code": "301061121",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.