Active NPI
Susan M Doran, PT
- Physical Therapist
- Virginia, MN
National Provider Identifier
1174795355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4277
- Practice address
- 901 9TH St N
Suite 100
Virginia, MN 55792-2325 - Phone
- (218) 749-9405
- Fax
- (218) 749-9407
- NPI assigned
- Mar 28, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4277 | MN | Primary |
Addresses
Primary practice location
901 9TH St N
Suite 100
Virginia, MN 55792-2325
Mailing address
901 9TH St N
Suite 100
Virginia, MN 55792-2325
Phone (218) 749-9405
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4277 | MN | MD | Sports Physician Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iron Range Rehabilitation Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Rehabilitation Clinic/Center
- Virginia, MN
- NPI 1316098445
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206662400000",
"number": "1174795355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 9TH ST N",
"address_2": "SUITE 100",
"city": "VIRGINIA",
"state": "MN",
"postal_code": "557922325",
"telephone_number": "218-749-9405",
"fax_number": "218-749-9407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 9TH ST N",
"address_2": "SUITE 100",
"city": "VIRGINIA",
"state": "MN",
"postal_code": "557922325",
"telephone_number": "218-749-9405",
"fax_number": "218-749-9407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORAN",
"first_name": "SUSAN",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-28",
"last_updated": "2008-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "4277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.