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SANCTUM INTEGRATED HEALTH SERVICES LLC
NPI 1720662455
Nurse Practitioner - Psychiatric/Mental Health in Elkton, MD

Active since May 10, 2021CLIA 21D2252206 · Waiver
224 E MAIN ST STE 119, ELKTON, MD 21921(866) 472-6288(856) 389-5716 Get Directions Write a Review

NPPES record last updated: September 2, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 2, 2022, Jan 27, 2022, Jul 26, 2021 and 1 more (4 updates tracked since 2021).

About Sanctum Integrated Health Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANCTUM INTEGRATED HEALTH SERVICES LLC (NPI 1720662455) is a healthcare organization registered as a psychiatric/mental health in Elkton, Maryland and active in the NPI registry since May 2021. The organization holds a CLIA Waiver certificate valid through February 8, 2028 and lists Nina C. Lane, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1720662455
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameSANCTUM INTEGRATED HEALTH SERVICES LLC
Location Address224 E MAIN ST STE 119Elkton, MD 21921-5790
Mailing Address224 E Main St Ste 119Elkton, MD 21921-5790 · (866) 472-6288 · Fax (856) 389-5716
Phone(866) 472-6288
Fax(856) 389-5716
Organization SubpartNo
Authorized OfficialNina C. LaneNurse Practitioner · (866) 472-6288
Enumeration DateMay 10, 2021
Last NPPES UpdateSeptember 2, 20224 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2022
✔ NPI 1720662455 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X
224 E MAIN ST STE 119, Elkton, MD 21921
Open in Google Maps ↗

Other Identifiers 2

OtherL04095926355682NJ · Dl
Medicaid907607700MD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sanctum Integrated Health Services Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Sanctum Integrated Health Services LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Nina Lane, NP
Nurse Practitioner
NPI 1104220011
224 E MAIN ST STE 119
Elkton, MD 21921
(866) 472-6288
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2252206

Sanctum Integrated Health Services LLC · Elkton, MD
Active · expires Feb 8, 2028
CLIA Number21D2252206
Laboratory TypePractitioner Other
Certificate Effective DateFebruary 9, 2026
Certificate Expiration DateFebruary 8, 2028
Laboratory DirectorNina Lane
Laboratory Phone(866) 472-6288
Laboratory LocationSanctum Integrated Health Services LLC224 E Main St Ste 119, Elkton, MD 21921
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sanctum Integrated Health Services LLC's NPI number?

The NPI number for Sanctum Integrated Health Services LLC is 1720662455. It was assigned to this organization in the NPPES registry on May 10, 2021.

Where is Sanctum Integrated Health Services LLC located?

Sanctum Integrated Health Services LLC is located at 224 E Main St Ste 119, Elkton, MD 21921. The listed phone number is (866) 472-6288.

What is Sanctum Integrated Health Services LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Sanctum Integrated Health Services LLC enrolled in Medicare?

Yes. Sanctum Integrated Health Services LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Sanctum Integrated Health Services LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Sanctum Integrated Health Services LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Sanctum Integrated Health Services LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2252206) is associated with this NPI, valid through February 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sanctum Integrated Health Services LLC was last updated on September 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.