Provider Demographics
NPI:1275684839
Name:STERLING PHYSICAL THERAPY & ASSOCIATES PSC
Entity Type:Organization
Organization Name:STERLING PHYSICAL THERAPY & ASSOCIATES PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:BAXTER
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:859-498-0011
Mailing Address - Street 1:113 MALONEY WAY
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353
Mailing Address - Country:US
Mailing Address - Phone:859-498-0011
Mailing Address - Fax:859-498-5001
Practice Address - Street 1:209 EVANS AVE
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9700
Practice Address - Country:US
Practice Address - Phone:859-498-0011
Practice Address - Fax:859-498-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY100904225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000375789OtherANTHEM
KY87001509Medicaid
KY87001616Medicaid
KY375791OtherANTHEM
KY375792OtherANTHEM
KY87001616Medicaid