Individual provider Active NPI

Susan Mary McClain, MPT, CERT. MDT

  • Physical Therapist
  • Wilmington, DE
National Provider Identifier
1194887091
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
J1-0000969 Issued in DE
Practice address
2100 Baynard Blvd
Lower Level
Wilmington, DE 19802-3900
Phone
(302) 655-5877
Fax
(302) 655-0825
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X J1-0000969 DE Primary
Physical Therapist 225100000X PT0009272L PA

Addresses

Primary practice location

2100 Baynard Blvd
Lower Level
Wilmington, DE 19802-3900

Mailing address

3411 Silverside Rd
Suite 105 Springer BLDG
Wilmington, DE 19810-4812
Phone (302) 655-5877

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
J1-0000969DEMDPhysical Therapist
PT0009272LPAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194887091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 SILVERSIDE RD",
            "address_2": "SUITE 105 SPRINGER BLDG",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104812",
            "telephone_number": "302-655-5877",
            "fax_number": "302-655-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 BAYNARD BLVD",
            "address_2": "LOWER LEVEL",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198023900",
            "telephone_number": "302-655-5877",
            "fax_number": "302-655-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLAIN",
        "first_name": "SUSAN",
        "middle_name": "MARY",
        "credential": "MPT, CERT. MDT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J1-0000969",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT0009272L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

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.

Verify at the official NPI Registry.