Provider Demographics
NPI:1285022459
Name:KINGSLEY, SARAH APPLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:APPLE
Last Name:KINGSLEY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JENA
Other - Last Name:APPLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:3600 PARK RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-4102
Mailing Address - Country:US
Mailing Address - Phone:980-999-4533
Mailing Address - Fax:
Practice Address - Street 1:3600 PARK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-4102
Practice Address - Country:US
Practice Address - Phone:980-999-4533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-22
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP15063225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1285022459Medicaid