Active NPI
Susanne Shaw Jansen, PT, DPT
- Physical Therapist
- Anderson, SC
National Provider Identifier
1205475993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10059
- Practice address
- 2005 E Greenville St Ste 119
Anderson, SC 29621-1575 - Phone
- (864) 964-0505
- NPI assigned
- Dec 30, 2019
- 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 | 10059 | SC | Primary |
Addresses
Primary practice location
2005 E Greenville St Ste 119
Anderson, SC 29621-1575
Mailing address
607 Visage Dr
Anderson, SC 29626-4054
Phone (864) 934-1837
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 |
|---|---|---|---|
| 10059 | SC | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577664000000",
"number": "1205475993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "607 VISAGE DR",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296264054",
"telephone_number": "864-934-1837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2005 E GREENVILLE ST STE 119",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296211575",
"telephone_number": "864-964-0505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANSEN",
"first_name": "SUSANNE",
"middle_name": "SHAW",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-30",
"last_updated": "2019-12-30",
"certification_date": "2019-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "10059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anderson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.