Sandra Willett

Individual provider Active NPI Physical Therapy Assistant · Somerset, KY

NPI 1154522076 · NPPES record last updated Feb 26, 2025

Key facts

NPI
1154522076
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
A00749 (KY)
Practice address
175 Medpark Dr
Somerset, KY 42503-2734
Phone
(606) 679-1761
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A00749KYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Hills Therapy Services LLC Physical Therapy Assistant Past Accepting new patients
Southern Hills Therapy Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A00749 KY Yes

Addresses

Primary practice location

175 Medpark Dr
Somerset, KY 42503-2734

Mailing address

77 Warrick Rd
Monticello, KY 42633-2680
Phone (606) 217-3074

Other practice location 1

398 Fincastle Rd
Winchester, OH 45697-9783
Phone (937) 695-0839

Other providers in Somerset, KY

All providers in Somerset, KY · Physical Therapy Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.