John J Susan, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA 15708 Issued in FL

Practice address

147 Homestead Ave
Debary, FL 32713-3875

Phone

(386) 668-1156

Fax

(386) 668-2256

NPI assigned

Jun 26, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• John J Susan Lpta LLC

  • Physical Therapy Assistant
  • Debary, FL
  • NPI 1790924462
  NPD (past) Authorized official

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1174785778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530241",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327530241",
            "telephone_number": "386-668-1156",
            "fax_number": "386-668-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 HOMESTEAD AVE",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327133875",
            "telephone_number": "386-668-1156",
            "fax_number": "386-668-2256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSAN",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 15708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Debary, FL
• Providers in Debary, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; 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.