Healthcare Provider Details

I. General information

NPI: 1982793998
Provider Name (Legal Business Name): JUSTIN SACRIPANTE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 KILDAIRE FARM RD
CARY NC
27511-4523
US

IV. Provider business mailing address

1110 KILDAIRE FARM RD
CARY NC
27511-4523
US

V. Phone/Fax

Practice location:
  • Phone: 919-481-0277
  • Fax:
Mailing address:
  • Phone: 919-481-0227
  • Fax: 919-481-7777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-05956
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: