Individual provider Active NPI

Sarah Marie Dahl, DPT

  • Physical Therapist
  • Appleton, WI
National Provider Identifier
1790209112
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13937 Issued in WI
Practice address
4000 N Providence Ave
Appleton, WI 54913-8018
Phone
(920) 968-0814
Fax
(920) 734-6159
NPI assigned
Jul 27, 2017
Last updated
Mar 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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 13937 WI Primary

Addresses

Primary practice location

4000 N Providence Ave
Appleton, WI 54913-8018

Mailing address

1000 Midway Rd
Menasha, WI 54952-1116
Phone (920) 257-2000

Other names 1

  • Sarah Marie Jacobs Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171027000668 WI Practitioner - Physical Therapist in Private Practice 6103192653 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Care of Wisconsin SCGroup PAC ID 3072416601, 23 clinicians
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

3232 N Ballard Rd
Suite 100
Appleton, WI 54911-8804
Phone (920) 729-7105

825 Cobblestone LN
Kimberly, WI 54136-2116
Phone (800) 444-6845

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13937WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Care of Wisconsin S.C. CurrentSince Oct 1, 2024 Accepting new patients
Theda Clark OB Hospitalists SC CurrentSince Oct 1, 2024 Accepting new patients
Aegis Group Practice LLC Physical Therapist Current Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Nov 6, 2024 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Nov 6, 2024 Accepting new patients

Locations

3232 N Ballard Rd
Ste 100
Appleton, WI 54911

3232 N Ballard Rd
Ste 204
Appleton, WI 54911
Phone 92072929821270

E3277 Apple Tree Ln
Waupaca, WI 54981
Phone (715) 256-0358

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1790209112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MIDWAY RD",
            "city": "MENASHA",
            "state": "WI",
            "postal_code": "549521116",
            "telephone_number": "920-257-2000",
            "fax_number": "920-257-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 N PROVIDENCE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549138018",
            "telephone_number": "920-968-0814",
            "fax_number": "920-734-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "SARAH",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "JACOBS",
            "middle_name": "MARIE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.