Active NPI
Sarah Tidswell, PT
- Physical Therapist
- Simpsonville, SC
National Provider Identifier
1124336516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6079
- Practice address
- 219 Gerald Dr
Simpsonville, SC 29681-4111 - Phone
- (864) 483-2992
- Fax
- (864) 757-9209
- NPI assigned
- Sep 20, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6079 | SC | Primary |
Addresses
Primary practice location
219 Gerald Dr
Simpsonville, SC 29681-4111
Mailing address
219 Gerald Dr
Simpsonville, SC 29681-4111
Phone (864) 483-2992
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6079 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284940800000",
"number": "1124336516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "219 GERALD DR",
"city": "SIMPSONVILLE",
"state": "SC",
"postal_code": "296814111",
"telephone_number": "864-483-2992",
"fax_number": "864-757-9209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "219 GERALD DR",
"city": "SIMPSONVILLE",
"state": "SC",
"postal_code": "296814111",
"telephone_number": "864-483-2992",
"fax_number": "864-757-9209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIDSWELL",
"first_name": "SARAH",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-20",
"last_updated": "2010-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "6079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Simpsonville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.