Individual provider Active NPI

Sarah Anne Pearson, DO

  • Student in an Organized Health Care Education/Training Program
  • Tahlequah, OK
National Provider Identifier
1013777895
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
9155 Issued in OK
Practice address
19600 E Ross St
Tahlequah, OK 74464-0545
Phone
(539) 302-4172
NPI assigned
Mar 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NM
Student in an Organized Health Care Education/Training Program 390200000X 9155 OK Primary

Addresses

Primary practice location

19600 E Ross St
Tahlequah, OK 74464-0545

Mailing address

4339 Bastille Dr
Kernersville, NC 27284-2031
Phone (336) 618-3714

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
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
9155OKMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1013777895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4339 BASTILLE DR",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842031",
            "telephone_number": "336-618-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19600 E ROSS ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744640545",
            "telephone_number": "539-302-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "SARAH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-20",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": "9155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; 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.