Individual provider Active NPI

Susan L Kissel, PTA

  • Physical Therapy Assistant
  • Hanover Township, PA
National Provider Identifier
1295986974
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
TE04080L Issued in PA
Practice address
1548 Sans Souci Pkwy
Hanover Township, PA 18706-6028
Phone
(570) 825-8725
NPI assigned
Oct 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X TE04080L PA Primary

Addresses

Primary practice location

1548 Sans Souci Pkwy
Hanover Township, PA 18706-6028

Mailing address

190 Cragle Hill Rd
Shickshinny, PA 18655-4611
Phone (570) 542-7677

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
TE04080LPAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1295986974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 CRAGLE HILL RD",
            "city": "SHICKSHINNY",
            "state": "PA",
            "postal_code": "186554611",
            "telephone_number": "570-542-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1548 SANS SOUCI PKWY",
            "city": "HANOVER TOWNSHIP",
            "state": "PA",
            "postal_code": "187066028",
            "telephone_number": "570-825-8725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSEL",
        "first_name": "SUSAN",
        "middle_name": "L",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE04080L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover Township, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.

Verify at the official NPI Registry.