Active NPI
Sara White, PTA
- Physical Therapy Assistant
- Waukon, IA
National Provider Identifier
1275657967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 00967
- Practice address
- 40 1St St SE
Waukon, IA 52172-2022 - Phone
- (563) 568-3411
- NPI assigned
- Mar 19, 2007
- Last updated
- Jul 8, 2007
- 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 Therapy Assistant | 225200000X | 00967 | IA | Primary |
Addresses
Primary practice location
40 1St St SE
Waukon, IA 52172-2022
Mailing address
230 East Williams Street
PO Box 32
Postville, IA 52162
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 |
|---|---|---|---|
| 00967 | IA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275657967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 EAST WILLIAMS STREET",
"address_2": "PO BOX 32",
"city": "POSTVILLE",
"state": "IA",
"postal_code": "52162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 1ST ST SE",
"city": "WAUKON",
"state": "IA",
"postal_code": "521722022",
"telephone_number": "563-568-3411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "SARA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IA",
"license": "00967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waukon, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.