Sarah Gardner, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05012083A Issued in IN

Practice address

9302 N Meridian St
Ste 190
Indianapolis, IN 46260-1873

Phone

(317) 843-1270

Fax

(317) 843-1270

NPI assigned

Jun 24, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Sarah Lickteig Former name

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northland Physical Therapy and Rehab Services IncGroup PAC ID 1850370453, 120 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northland Physical Therapy & Rehab Services, Inc

  • Physical Therapist
  • N Kansas City, MO
  • NPI 1740273218

  KS

  Medicare reassignment Care Compare group NPD
• Dickson Diveley Midwest Orthopaedic Clinic LLC

  • Orthopaedic Surgery Physician
  • Leawood, KS
  • NPI 1669421509
  NPD (past)

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1194130591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9302 N MERIDIAN ST",
            "address_2": "STE 190",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601873",
            "telephone_number": "317-843-1270",
            "fax_number": "317-843-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "SARAH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-04850",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05012083A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "LICKTEIG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gregory Jan Gardner, D.D.S.
• Holly A Gardner, MD
• Jordan Gardner
• Kelley Gardner, LMFT
• Olivia Catherine Gardner, BT
• Sean E Gardner, MD
• Stephanie M Gardner, MD
• Thomas A Gardner, MD
• Venice Mae Gardner, OTR
• Gareuhpist Counseling & Consulting LLC

• Physical Therapist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.