Active NPI
Susan M Sjoberg, PT
- Specialist
- Presque Isle, ME
National Provider Identifier
1174554828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- ME 720
- Practice address
- 96 Houlton Road
Presque Isle, ME 04769 - Phone
- (207) 764-6242
- Fax
- (207) 764-6242
- NPI assigned
- Jul 5, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | ME 720 | ME | Primary |
Addresses
Primary practice location
96 Houlton Road
Presque Isle, ME 04769
Mailing address
PO Box 4063
Presque Isle, ME 04769-4063
Phone (207) 764-6242
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 039498 | Other | ME | ANTHEM BLUE CROSS |
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 |
|---|---|---|---|
| ME 720 | ME | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174554828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4063",
"city": "PRESQUE ISLE",
"state": "ME",
"postal_code": "047694063",
"telephone_number": "207-764-6242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "96 HOULTON ROAD",
"city": "PRESQUE ISLE",
"state": "ME",
"postal_code": "04769",
"telephone_number": "207-764-6242",
"fax_number": "207-764-6242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SJOBERG",
"first_name": "SUSAN",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "ME",
"license": "ME 720",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "039498",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Presque Isle, ME
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.