Individual provider Active NPI

Sarah Teague, PTA

  • Physical Therapy Assistant
  • Springfield, IL
National Provider Identifier
1013389998
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160006977 Issued in IL
Practice address
631 Foxtail LN
Springfield, IL 62707-8596
Phone
(217) 652-7780
NPI assigned
Oct 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160006977 IL Primary

Addresses

Primary practice location

631 Foxtail LN
Springfield, IL 62707-8596

Mailing address

631 Foxtail LN
Springfield, IL 62707-8596
Phone (217) 652-7780

Other identifiers 1

IdentifierTypeStateIssuer
160006977OtherDEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
160006977ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1013389998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 FOXTAIL LN",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627078596",
            "telephone_number": "217-652-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 FOXTAIL LN",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627078596",
            "telephone_number": "217-652-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEAGUE",
        "first_name": "SARAH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160006977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION",
            "identifier": "160006977",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.