Individual provider Active NPI

Susan Duttweiler, P.T., CEAS, CFCE

  • Physical Therapist
  • Bradenton, FL
National Provider Identifier
1275661548
Registry record updated Aug 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28189 Issued in FL
Practice address
1105 53Rd Ave E Ste a
Bradenton, FL 34203-4897
Phone
(941) 755-2562
Fax
(941) 758-4065
NPI assigned
Mar 1, 2007
Last updated
Aug 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT28189 FL Primary
Physical Therapist 225100000X 05001508A IN
Physical Therapist 225100000X 070004271 IL
Physical Therapist 225100000X 010833 GA

Addresses

Primary practice location

1105 53Rd Ave E Ste a
Bradenton, FL 34203-4897

Mailing address

28035 Avenue Sanford West
Valencia, CA 91355
Phone (219) 545-9057

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

LicenseStateTypeSpecialty
PT28189FLMDPhysical Therapist
010833GAMDPhysical Therapist
070004271ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
U.S. Healthworks Medical Group of Florida, Inc. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1275661548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28035 AVENUE SANFORD WEST",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "91355",
            "telephone_number": "219-545-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 53RD AVE E STE A",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342034897",
            "telephone_number": "941-755-2562",
            "fax_number": "941-758-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTWEILER",
        "first_name": "SUSAN",
        "name_prefix": "Ms.",
        "credential": "P.T., CEAS, CFCE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28189",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05001508A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070004271",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "010833",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; 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.