Active NPI
Suzan Rheault
- Physical Therapist
- Salem, NH
National Provider Identifier
1063962108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT6023715
- Practice address
- 2 Keewaydin Dr
Salem, NH 03079-2839 - Phone
- (800) 955-6273
- Fax
- (888) 979-6551
- NPI assigned
- Oct 13, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PHYP1707 | AK | |
| Physical Therapist | 225100000X | PTP-PT-LIC-6221 | MT | |
| Physical Therapist | 225100000X | 7015 | MA | |
| Physical Therapist | 225100000X | PT-1966 | ID | |
| Physical Therapist | 225100000X | PT6023715 | WA | Primary |
Addresses
Primary practice location
2 Keewaydin Dr
Salem, NH 03079-2839
Mailing address
2 Keewaydin Dr
Salem, NH 03079-2839
Phone (800) 955-6273
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
| License | State | Type | Specialty |
|---|---|---|---|
| PHYP1707 | AK | MD | Physical Therapist |
| PT-1966 | ID | MD | Physical Therapist |
| 7015 | MA | MD | Physical Therapist |
| PTP-PT-LIC-6221 | MT | MD | Physical Therapist |
| PT6023715 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709251200000",
"number": "1063962108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 KEEWAYDIN DR",
"city": "SALEM",
"state": "NH",
"postal_code": "030792839",
"telephone_number": "800-955-6273",
"fax_number": "888-979-6551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 KEEWAYDIN DR",
"city": "SALEM",
"state": "NH",
"postal_code": "030792839",
"telephone_number": "800-955-6273",
"fax_number": "888-979-6551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RHEAULT",
"first_name": "SUZAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-13",
"last_updated": "2024-03-01",
"certification_date": "2024-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AK",
"license": "PHYP1707",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MT",
"license": "PTP-PT-LIC-6221",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "7015",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-1966",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT6023715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.