Individual provider Active NPI

Sarah Wallace, PT, MS

  • Physical Therapist
  • Worthington, OH
National Provider Identifier
1609649813
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT018364 Issued in OH
Practice address
965 High St
Worthington, OH 43085-4057
Phone
(614) 784-0400
Fax
(614) 784-0401
NPI assigned
Oct 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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 PT018364 OH Primary

Addresses

Primary practice location

965 High St
Worthington, OH 43085-4057

Mailing address

PO Box 542
Cedarville, OH 45314-0542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240112002441 OH Practitioner - Physical Therapist in Private Practice 0547611691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Outpatient at Home LLCGroup PAC ID 6204248784, 38 clinicians

Practice addresses (Care Compare)

965 High St
Worthington, OH 43085-4065
Phone (614) 784-0400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PT018364OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Physical Therapy, LLC Physical Therapist PastSince Nov 1, 2023 Accepting new patients

Organizations & group practices 2

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": "1698710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1609649813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 542",
            "city": "CEDARVILLE",
            "state": "OH",
            "postal_code": "453140542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 HIGH ST",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430854057",
            "telephone_number": "614-784-0400",
            "fax_number": "614-784-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SARAH",
        "credential": "PT, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT018364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2023; 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.