Sarah Elise Blackledge, DPT
Individual provider Active NPI Physical Therapist · Petal, MS
NPI 1972917367 · NPPES record last updated Jul 20, 2020
Key facts
- NPI
- 1972917367
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- Practice address
- 206 Old Corinth Rd
Petal, MS 39465-2932 - Phone
- (601) 583-9464
- Fax
- (601) 583-9465
- NPI assigned
- Jun 13, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hattiesburg Clinic PA | Current |
Accepting new patients | |
| Hattiesburg Clinic, PA | Current |
Accepting new patients |
Locations
7148 U S Highway 98
Ste 102
Hattiesburg, MS 39402
Phone (601) 261-1500
415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606
415 S 28th Ave
Ste 4
Hattiesburg, MS 39401
206 Old Corinth Rd
Petal, MS 39465
Phone (601) 544-7404
1403 S Main St
Ste E
Poplarville, MS 39470
Phone (601) 268-5757
98 Shelby Speights Dr
Purvis, MS 39475
Phone (601) 794-2402
Interoperability endpoints
- eholifield40795@directpatientrecord.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Yes |
Addresses
Primary practice location
206 Old Corinth Rd
Petal, MS 39465-2932
Mailing address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 583-9464
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 05538733 | Medicaid | MS |
Other names
- Sarah Elise Holifield
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | eholifield40795@directpatientrecord.com | Health Information Exchange (HIE) |
Other providers in Petal, MS
- Hannah Roberts Badon
- Jennifer Lois Barbieri
- Bedford Care Center of Petal, LLC
- Lawrence C Bender III
- Alisa Berteau
- Dee C Blackwell
- Allison Joy Boutwell
- Bobby Glenn Braswell Jr.
- Trish Anne Brix-Baskin
- Lauren Brown
All providers in Petal, MS · Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.