Active NPI
Sarah E. Boulden, P.T.A.
- Physical Therapy Assistant
- Chestertown, MD
National Provider Identifier
1790944262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A2941
- Practice address
- 818 High St
Suite 1
Chestertown, MD 21620-1152 - Phone
- (410) 778-6565
- Fax
- (410) 778-6536
- NPI assigned
- Jun 9, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A2941 | MD | Primary |
Addresses
Primary practice location
818 High St
Suite 1
Chestertown, MD 21620-1152
Mailing address
818 High St
Suite 1
Chestertown, MD 21620-1152
Phone (410) 778-6565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 216582 | Other | MD | MEDICARE PART A |
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
| License | State | Type | Specialty |
|---|---|---|---|
| A2941 | MD | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chestertown Physical Therapy Services, Inc. | Past | Accepting new patients |
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.
-
- Physical Therapist
- Chestertown, MD
- NPI 1689642696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234396800000",
"number": "1790944262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "818 HIGH ST",
"address_2": "SUITE 1",
"city": "CHESTERTOWN",
"state": "MD",
"postal_code": "216201152",
"telephone_number": "410-778-6565",
"fax_number": "410-778-6536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "818 HIGH ST",
"address_2": "SUITE 1",
"city": "CHESTERTOWN",
"state": "MD",
"postal_code": "216201152",
"telephone_number": "410-778-6565",
"fax_number": "410-778-6536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOULDEN",
"first_name": "SARAH",
"middle_name": "E.",
"credential": "P.T.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-09",
"last_updated": "2009-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A2941",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PART A",
"identifier": "216582",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chestertown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.