Sarah Ellen Repp, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4001 Issued in NV

Practice address

1658 Boulder City Pkwy
Boulder City, NV 89005-1904

Phone

(702) 530-6329

Fax

(702) 952-5417

NPI assigned

Mar 6, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sarah Ellen Kisch Other name

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Champion Physical TherapyGroup PAC ID 7012374168, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Champion Physical Therapy

  • Physical Therapist
  • Boulder City, NV
  • NPI 1265148217
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1588122758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1658 BOULDER CITY PKWY",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890051904",
            "telephone_number": "702-530-6329",
            "fax_number": "702-952-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1658 BOULDER CITY PKWY",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890051904",
            "telephone_number": "702-530-6329",
            "fax_number": "702-952-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REPP",
        "first_name": "SARAH",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-06",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "4001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "KISCH",
            "middle_name": "ELLEN",
            "credential": "DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Physical Therapist in Boulder City, NV
• Providers in Boulder City, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.