Individual provider Active NPI

Suzannah Kathryn York - Crump, PT

  • Physical Therapist
  • Shreveport, LA
National Provider Identifier
1003046079
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
07638 Issued in LA
Practice address
266 Ockley Dr
Shreveport, LA 71105-3025
Phone
(337) 580-0083
Fax
(337) 580-0083
NPI assigned
Jul 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 07638 LA Primary

Addresses

Primary practice location

266 Ockley Dr
Shreveport, LA 71105-3025

Mailing address

290 Raes CRK
Shreveport, LA 71106-8376
Phone (337) 580-0083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140916000682 LA Practitioner - Physical Therapist in Private Practice 4587883079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Studio P3 LLCGroup PAC ID 6507085099, 3 clinicians

Practice addresses (Care Compare)

855 Pierremont Rd
Suite 107
Shreveport, LA 71106-2040
Phone (318) 868-3268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Studio P3, LLC Physical Therapist CurrentSince May 1, 2014 Accepting new patients

Locations

855 Pierremont Rd
Ste 107
Shreveport, LA 71106
Phone (318) 868-3268

266 Ockley Dr
Shreveport, LA 71105
Phone (318) 868-3268

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1003046079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 RAES CRK",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068376",
            "telephone_number": "337-580-0083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 OCKLEY DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711053025",
            "telephone_number": "337-580-0083",
            "fax_number": "337-580-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORK - CRUMP",
        "first_name": "SUZANNAH",
        "middle_name": "KATHRYN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "07638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.