SANCTUARY INTEGRATIVE MEDICINE PC (NPI# 1568615441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568615441 |
| Entity Type | Organization |
| Organization Name | SANCTUARY INTEGRATIVE MEDICINE PC |
| Practice Address |
90 Mahoney Ave Rutland VT 05701-4836 |
| Practice Telephone | 8027757848 |
| Practice Fax Number | 8027745145 |
| Mailing Telephone | 8027757848 |
| Mailing Fax Number | 8027745145 |
| Enumeration Date | 2008-10-23 |
| Last Update Date | 2010-06-18 |
| Authorized Official Name | MARK E LOGAN (PROVIDER) |
| Authorized Official Telephone | 8027757848 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
0420006819 | VT | Allopathic & Osteopathic Physicians |
| Street Address |
90 MAHONEY AVE |
| City | RUTLAND |
| State | VT |
| Zip Code | 05701-4836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063448694 | Bridget Leicester | Social Worker | 90 Mahoney Ave, Psychiatry & Psychotherapy Assocs, Rutland, VT 05701-0000 | 2006-06-24 |
| 1376186551 | Nina Elaine Gee | Acupuncturist | 90 Mahoney Ave, Rutland, VT 05701-4836 | 2019-10-21 |
| 1992248314 | Nina Gee, Ms Lac | Acupuncturist | 90 Mahoney Ave, Rutland, VT 05701-4836 | 2016-12-02 |
| 1669731477 | Life Source Chiropractic Inc. | Chiropractor | 90 Mahoney Ave, Rutland, VT 05701-4836 | 2012-05-14 |
| 1497087159 | Jared Galster | Chiropractor | 90 Mahoney Ave, Rutland, VT 05701-4836 | 2010-02-05 |
| 1578765285 | Dalite Sancic | Acupuncturist | 90 Mahoney Ave, Rutland, VT 05701-4836 | 2007-06-04 |
| 1104034529 | Psychotherapy Associates | Psychologist | 90 Mahoney Ave, Rutland, VT 05701 | 2007-05-18 |
| 1780742551 | Ann M Friedman | Counselor | 90 Mahoney Ave, Rutland, VT 05701 | 2006-12-05 |
| 1215007067 | Alban J Coghlan | Psychiatry & Neurology | 90 Mahoney Ave, Rutland, VT 05701 | 2006-11-09 |
| 1912914607 | Gail R Coghlow | Psychologist | 90 Mahoney Ave, Rutland, VT 05701-4836 | 2006-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639721186 | All Dimensions Primary Care Pllc | Physician Assistant | 92 Allen Street, Rutland, VT 05701 | 2019-07-15 |
| 1962809053 | Laura Kalinen Laprise | Nurse Practitioner | Rutland Community Health Center, 215 Stratton Road, Rutland, VT 05701 | 2014-12-04 |
| 1962818781 | Andrea Louise Welch | Pharmacist | 1 Rutland Shopping Plaza, Rutland, VT 05701 | 2014-07-02 |
| 1396158903 | Gwendolyn Koenig | Counselor | 78 South Main St., Rutland, VT 05701 | 2014-06-11 |
| 1194088195 | Marcie Bouchard | Early Intervention Provider Agency | 24a East Street, Rutland, VT 05701 | 2012-06-25 |
| 1790047009 | Pamela Lenoci | Massage Therapist | 196 Joshua Place, Rutland, VT 05701 | 2012-06-12 |
| 1528339959 | Deborah E. Boston | Social Worker | 128 Merchants Row Ste 510, Rutland, VT 05701 | 2012-01-17 |
| 1235431834 | Alicia Marie Riesterer | Occupational Therapy Assistant | 46 Nichols St., Rutland Healthcare and Rehabilitation Center, Rutland, VT 05701 | 2010-12-02 |
| 1497085401 | Lauren Ann Lasante | Counselor | 198 N Main St Ste C-5, Rutland, VT 05701 | 2010-01-14 |
| 1568692515 | Steven C. Duboff, Dmd, PC | Dentist | 198 North Main St, Rutland, VT 05701 | 2009-07-23 |
| Find all providers in zip 05701 | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407983125 | Jared Egerton Florance | Preventive Medicine | 789 Vermont National Guard Rd, Vtarng State Medical Detachment, Colchester, VT 05446-6358 | 2007-02-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.