=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457234304
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH SCOTT MCPHERSON PTA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/29/2025
-----------------------------------------------------
Last Update Date | 07/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 205 COUNTRY CLUB PARK
-----------------------------------------------------
City | MOUNTAIN BRK
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35213-4237
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-871-0777
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 205 COUNTRY CLUB PARK
-----------------------------------------------------
City | MOUNTAIN BRK
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35213-4237
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-871-0777
-----------------------------------------------------
Fax | 205-871-0701
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | PTA11563
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------