Individual provider Active NPI

Sarah Rachel Holst, PT, DPT

  • Physical Therapist
  • Kailua Kona, HI
National Provider Identifier
1508414236
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
63389 Issued in OR
Practice address
75-5699 Kopiko St
Kailua Kona, HI 96740-3651
Phone
(808) 329-7744
Fax
(808) 334-1608
NPI assigned
Aug 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 63389 OR Primary

Addresses

Primary practice location

75-5699 Kopiko St
Kailua Kona, HI 96740-3651

Mailing address

2966 Wells Fargo Rd
Central Point, OR 97502-1128
Phone (541) 778-8397

Other practice location 1

242 N Phoenix Rd
Phoenix, OR 97535-9104
Phone (541) 512-0757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230303000212 DC Practitioner - Physical Therapist in Private Practice 5193158939 Reassigns benefits to 1 organization
I20230407001950 VA Practitioner - Physical Therapist in Private Practice 5193158939 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jackson Clinics Limited PartnershipGroup PAC ID 2860623295, 116 clinicians

Practice addresses (Care Compare)

43490 Yukon Dr
Ashburn, VA 20147-6990
Phone (703) 729-7920

5900 Fort Dr
Suite 208
Centreville, VA 20121-2425
Phone (703) 830-6360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Clinics Limited Partnership Physical Therapist CurrentSince Jan 23, 2023 Accepting new patients

Locations

43490 Yukon Dr
Ashburn, VA 20147
Phone (703) 729-7920

5900 Fort Dr
Ste 208
Centreville, VA 20121
Phone (703) 830-6360

12701 Fair Lakes Cir
Ste 102
Fairfax, VA 22033

119 The Plains Rd
Ste 100
Middleburg, VA 20117
Phone (540) 687-8181

Organizations & group practices 1

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": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1508414236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2966 WELLS FARGO RD",
            "city": "CENTRAL POINT",
            "state": "OR",
            "postal_code": "975021128",
            "telephone_number": "541-778-8397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-5699 KOPIKO ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967403651",
            "telephone_number": "808-329-7744",
            "fax_number": "808-334-1608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "242 N Phoenix Rd",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "OR",
            "postal_code": "975359104",
            "country_code": "US",
            "telephone_number": "541-512-0757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLST",
        "first_name": "SARAH",
        "middle_name": "RACHEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-27",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "63389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.