Individual provider Active NPI

Suzanne Jennifer Greenwalt, P.T.

  • Physical Therapist
  • Hermitage, TN
National Provider Identifier
1174784037
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6637 Issued in TN
Practice address
4347 Lebanon Pike
Hermitage, TN 37076-1243
Phone
(615) 871-8131
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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 6637 TN Primary

Addresses

Primary practice location

4347 Lebanon Pike
Hermitage, TN 37076-1243

Mailing address

4347 Lebanon Pike
Hermitage, TN 37076-1243
Phone (615) 871-8131

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
6637TNMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1174784037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4347 LEBANON PIKE",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761243",
            "telephone_number": "615-871-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4347 LEBANON PIKE",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370761243",
            "telephone_number": "615-871-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWALT",
        "first_name": "SUZANNE",
        "middle_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "6637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermitage, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.