Provider Demographics
NPI:1275816555
Name:ROOKER, SARAH W (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:W
Last Name:ROOKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:E
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:2270 ASHLEY CROSSING DR STE 110
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5749
Practice Address - Country:US
Practice Address - Phone:843-853-3474
Practice Address - Fax:843-853-3500
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1696363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1543PAMedicaid
SCAA84085872Medicare PIN
SCSC20219637Medicare PIN
SC1543PAMedicaid