Individual provider Active NPI

Sarah Cockrell Demoville, P.T.

  • Physical Therapist
  • Palm Coast, FL
National Provider Identifier
1912104688
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30531 Issued in FL
Practice address
650 Colbert LN
Palm Coast, FL 32137-4503
Phone
(904) 495-2912
Fax
(855) 232-8604
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1154823 TX
Physical Therapist 225100000X 30531 FL Primary

Addresses

Primary practice location

650 Colbert LN
Palm Coast, FL 32137-4503

Mailing address

650 Colbert LN
Palm Coast, FL 32137-4503
Phone (904) 495-2912

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
30531FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1912104688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 COLBERT LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374503",
            "telephone_number": "904-495-2912",
            "fax_number": "855-232-8604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 COLBERT LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321374503",
            "telephone_number": "904-495-2912",
            "fax_number": "855-232-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMOVILLE",
        "first_name": "SARAH",
        "middle_name": "COCKRELL",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1154823",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "30531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; 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.