Individual provider Active NPI

Suzanne Burke Allen, PT, DPT

  • Physical Therapist
  • Joint Base Langley-Eustis, VA
National Provider Identifier
1134523848
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5396 Issued in CO
Practice address
77 Nealy Avenue
633D Medical Group
Joint Base Langley-Eustis, VA 23665-2040
Phone
(757) 225-7630
NPI assigned
Oct 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2981 OR
Physical Therapist 225100000X 19874 MD
Physical Therapist 225100000X 6782 WA
Physical Therapist 225100000X 5396 CO Primary
Physical Therapist 225100000X 2305202396 VA
Physical Therapist 225100000X PT02247 RI
Physical Therapist 225100000X 531 AK
Physical Therapist 225100000X 010938 NY
Physical Therapist 225100000X 5469 GA
Physical Therapist 225100000X QA06877 NJ

Addresses

Primary practice location

77 Nealy Avenue
633D Medical Group
Joint Base Langley-Eustis, VA 23665-2040

Mailing address

77 Nealy Avenue
633D Medical Group
Joint Base Langley-Eustis, VA 23665-2040
Phone (757) 225-7630

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
5396COMDProfessional Counselor
19874MDMDSocial Worker
531AKMDPhysical Therapist
QA06877NJMDPhysical Therapist
PT02247RIMDPhysical Therapist
2305202396VAMDPhysical Therapist
6782WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1134523848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 NEALY AVENUE",
            "address_2": "633D MEDICAL GROUP",
            "city": "JOINT BASE LANGLEY-EUSTIS",
            "state": "VA",
            "postal_code": "236652040",
            "telephone_number": "757-225-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 NEALY AVENUE",
            "address_2": "633D MEDICAL GROUP",
            "city": "JOINT BASE LANGLEY-EUSTIS",
            "state": "VA",
            "postal_code": "236652040",
            "telephone_number": "757-225-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "SUZANNE",
        "middle_name": "BURKE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-09",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "2981",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19874",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "6782",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "5396",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305202396",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT02247",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "531",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010938",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "5469",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "QA06877",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joint Base Langley-Eustis, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.