Active NPI
Susan Grace McDiarmid, PT
- Physical Therapist
- Fairbanks, AK
National Provider Identifier
1063466407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1392
- Practice address
- 751 Old Richardson Hwy
#202
Fairbanks, AK 99701 - Phone
- (907) 455-4401
- Fax
- (907) 455-4402
- NPI assigned
- May 20, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1392 | AK | Primary |
Addresses
Primary practice location
751 Old Richardson Hwy
#202
Fairbanks, AK 99701
Mailing address
File 50469
Los Angeles, CA 90074-0469
Phone (530) 778-0200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1392 | Other | AK | PT LICENCE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063466407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FILE 50469",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900740469",
"telephone_number": "530-778-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "751 OLD RICHARDSON HWY",
"address_2": "#202",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "99701",
"telephone_number": "907-455-4401",
"fax_number": "907-455-4402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDIARMID",
"first_name": "SUSAN",
"middle_name": "GRACE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AK",
"license": "1392",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENCE #",
"identifier": "1392",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.