Sarah Bethany Petrisin, MSED, ATC, NCMT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0126000935 Issued in VA

Practice address

7473 Eisenhower St
Ventura, CA 93003-2485

Phone

(315) 591-1166

NPI assigned

Jan 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1124365028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7473 EISENHOWER ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032485",
            "telephone_number": "315-591-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7473 EISENHOWER ST",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032485",
            "telephone_number": "315-591-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRISIN",
        "first_name": "SARAH",
        "middle_name": "BETHANY",
        "credential": "MSED, ATC, NCMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126000935",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019007248",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "70569",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Ann Peterson, MD
• Nicholas Edward Peterson, MD
• Susan Yvonne Peterson
• Melissa Petitt
• Jacqueline Petris, RBT
• Jeffrey J. Petron, D.D.S.
• Petros K. Frousiakis, D.O., a Professional Corporation
• Nila Chari Petrowski, P.T.
• Laszlo Petruska, D.D.S.
• Anthony Pham

• Athletic Trainer in Ventura, CA
• Providers in Ventura, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.