Individual provider Active NPI

Sarah Gassman Wilbanks, OTR/L

  • Occupational Therapist
  • Charleston, SC
National Provider Identifier
1154430668
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1567 Issued in SC
Practice address
408 Folly Rd
Charleston, SC 29412-2625
Phone
(843) 762-3601
Fax
(843) 762-7074
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1567 SC Primary

Addresses

Primary practice location

408 Folly Rd
Charleston, SC 29412-2625

Mailing address

9 N Basilica Ave
Hanahan, SC 29410-8649
Phone (843) 478-4047

Other identifiers 1

IdentifierTypeStateIssuer
TH0665MedicaidSC

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hedgemark Brentwood Medical Services, Inc.-Dba PHC Home Health CurrentSince Jan 1, 2022 Accepting new patients
PHC Rehab, Inc Past Accepting new patients
PHC Rehab, Inc. Past Accepting new patients

Locations

408 Folly Rd
Charleston, SC 29412
Phone (843) 762-3601

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1154430668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 N BASILICA AVE",
            "city": "HANAHAN",
            "state": "SC",
            "postal_code": "294108649",
            "telephone_number": "843-478-4047",
            "fax_number": "843-762-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 FOLLY RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122625",
            "telephone_number": "843-762-3601",
            "fax_number": "843-762-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBANKS",
        "first_name": "SARAH",
        "middle_name": "GASSMAN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "1567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH0665",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.