Individual provider Active NPI

Susanne L. Worden, PT

  • Physical Therapist
  • Kansas City, KS
National Provider Identifier
1083746739
Registry record updated Sep 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11-00840 Issued in KS
Practice address
4810 State Ave
Wyandotte Therapy
Kansas City, KS 66102-1748
Phone
(913) 321-4567
Fax
(913) 321-6789
NPI assigned
Mar 9, 2007
Last updated
Sep 24, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2007

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 11-00840 KS Primary

Addresses

Primary practice location

4810 State Ave
Wyandotte Therapy
Kansas City, KS 66102-1748

Mailing address

2330 Shawnee Mission Pkwy
Medical Administrative Services of Ku Med, Ste. 312
Westwood, KS 66205-2005
Phone (913) 588-9000

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

State licenses

LicenseStateTypeSpecialty
840KSMDAddiction (Substance Use Disorder) Counselor
11-00840KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jayhawk Primary Care Inc Past Accepting new patients
Jayhawk Primary Care Inc Past Accepting new patients
Jayhawk Primary Care Inc Physical Therapist Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190592000000",
    "number": "1083746739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 SHAWNEE MISSION PKWY",
            "address_2": "MEDICAL ADMINISTRATIVE SERVICES OF KU MED, STE. 312",
            "city": "WESTWOOD",
            "state": "KS",
            "postal_code": "662052005",
            "telephone_number": "913-588-9000",
            "fax_number": "913-588-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 STATE AVE",
            "address_2": "WYANDOTTE THERAPY",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661021748",
            "telephone_number": "913-321-4567",
            "fax_number": "913-321-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORDEN",
        "first_name": "SUSANNE",
        "middle_name": "L.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-00840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.

Verify at the official NPI Registry.