Individual provider Active NPI

Susan Bellamy, PT

  • Physical Therapist
  • Ravenna, OH
National Provider Identifier
1063496172
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10960 Issued in OH
Practice address
533 E Main St
Ravenna, OH 44266-3218
Phone
(330) 297-9020
Fax
(330) 297-9094
NPI assigned
Dec 1, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10960 OH Primary
Physical Therapist 225100000X 10960 MA
Physical Therapist 225100000X 10960 NY

Addresses

Primary practice location

533 E Main St
Ravenna, OH 44266-3218

Mailing address

533 E Main St
Ravenna, OH 44266-3218
Phone (330) 297-9020

Other identifiers 1

IdentifierTypeStateIssuer
10960OtherOHOHIO OT PT ATC BOARD

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10960NYMDAddiction (Substance Use Disorder) Counselor
10960MAMDPhysical Therapist
10960OHMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063496172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 E MAIN ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663218",
            "telephone_number": "330-297-9020",
            "fax_number": "330-297-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 E MAIN ST",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442663218",
            "telephone_number": "330-297-9020",
            "fax_number": "330-297-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLAMY",
        "first_name": "SUSAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "10960",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "10960",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "10960",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO OT PT ATC BOARD",
            "identifier": "10960",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ravenna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.