Individual provider Active NPI

Sarah Hope Garbula, PTA

  • Physical Therapy Assistant
  • South Lyon, MI
National Provider Identifier
1831671551
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502005511 Issued in MI
Practice address
22180 Pontiac TRL Ste E
South Lyon, MI 48178-9097
Phone
(248) 446-0155
Fax
(248) 446-0177
NPI assigned
Aug 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X 5502005511 MI Primary

Addresses

Primary practice location

22180 Pontiac TRL Ste E
South Lyon, MI 48178-9097

Mailing address

22180 Pontiac TRL Ste E
South Lyon, MI 48178-9097
Phone (248) 446-0155

Other identifiers 1

IdentifierTypeStateIssuer
5502005511OtherMIPTA LICENSE

Other names 1

  • Sarah Hope Dacko Former name

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

LicenseStateTypeSpecialty
5502005511MIMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Extremity Institute of South Lyon, L.L.C. Single Specialty PastSince Jun 8, 2010 Accepting new patients
Plymouth Physical Therapy Specialists Limited Partnership Past 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, 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": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1831671551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22180 PONTIAC TRL STE E",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481789097",
            "telephone_number": "248-446-0155",
            "fax_number": "248-446-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22180 PONTIAC TRL STE E",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481789097",
            "telephone_number": "248-446-0155",
            "fax_number": "248-446-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARBULA",
        "first_name": "SARAH",
        "middle_name": "HOPE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502005511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE",
            "identifier": "5502005511",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "DACKO",
            "middle_name": "HOPE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Lyon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.