Individual provider Active NPI

Sarah Perrin, PTA

  • Physical Therapy Assistant
  • Shiloh, IL
National Provider Identifier
1356030779
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
160009767 Issued in IL
Practice address
1191 Fortune Blvd Ste 2
Shiloh, IL 62269-7474
Phone
(269) 944-8013
NPI assigned
May 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160009767 IL Primary

Addresses

Primary practice location

1191 Fortune Blvd Ste 2
Shiloh, IL 62269-7474

Mailing address

5008 Bristol Hill Dr
O Fallon, IL 62269-7349
Phone (269) 944-8013

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

LicenseStateTypeSpecialty
160009767ILMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1356030779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 BRISTOL HILL DR",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622697349",
            "telephone_number": "269-944-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 FORTUNE BLVD STE 2",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622697474",
            "telephone_number": "269-944-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRIN",
        "first_name": "SARAH",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160009767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiloh, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.