Active NPI
Susanne Lynn Novotny, LMT, CDA
- Mechanotherapist
- Katy, TX
National Provider Identifier
1194019364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- MT112219
- Practice address
- 2126 Crystal Downs Dr
Katy, TX 77450-8666 - Phone
- (832) 389-6692
- NPI assigned
- Jun 6, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MT112219 | TX | Primary |
| Massage Therapist | 225700000X | MT112219 | TX |
Addresses
Primary practice location
2126 Crystal Downs Dr
Katy, TX 77450-8666
Mailing address
2126 Crystal Downs Dr
Katy, TX 77450-8666
Phone (832) 389-6692
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 |
|---|---|---|---|
| MT112219 | TX | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307923200000",
"number": "1194019364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2126 CRYSTAL DOWNS DR",
"city": "KATY",
"state": "TX",
"postal_code": "774508666",
"telephone_number": "832-389-6692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2126 CRYSTAL DOWNS DR",
"city": "KATY",
"state": "TX",
"postal_code": "774508666",
"telephone_number": "832-389-6692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOVOTNY",
"first_name": "SUSANNE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "LMT, CDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-06",
"last_updated": "2011-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "TX",
"license": "MT112219",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TX",
"license": "MT112219",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.