Individual provider Active NPI

Sara Kidder, DPT

  • Physical Therapist
  • Columbus, GA
National Provider Identifier
1851780811
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
038377 Issued in NY
Practice address
2515 Double Churches Rd
Columbus, GA 31909-2742
Phone
(706) 660-5495
NPI assigned
Jan 14, 2015
Last updated
May 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2021

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 038377 NY Primary

Addresses

Primary practice location

2515 Double Churches Rd
Columbus, GA 31909-2742

Mailing address

2515 Double Churches Rd
Columbus, GA 31909-2742
Phone (706) 660-5495

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231018004176 WV Practitioner - Physical Therapist in Private Practice 9234482712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Developmental Therapy Center IncGroup PAC ID 4486957370, 5 clinicians

Practice addresses (Care Compare)

803 7TH Ave
Huntington, WV 25701-2117
Phone (304) 523-1164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038377NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Developmental Therapy Center, Inc. Physical Therapist CurrentSince Jul 31, 2023 Accepting new patients

Locations

803 7th Ave
Huntington, WV 25701
Phone (304) 523-1164

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, 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": "1421193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1851780811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 DOUBLE CHURCHES RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092742",
            "telephone_number": "706-660-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 DOUBLE CHURCHES RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319092742",
            "telephone_number": "706-660-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDDER",
        "first_name": "SARA",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-14",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "038377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.