Individual provider Active NPI

Susan Leigh Edmond, PT

  • Physical Therapist
  • Short Hills, NJ
National Provider Identifier
1306067855
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00204700 Issued in NJ
Practice address
43 Elmwood PL
Short Hills, NJ 07078-3320
Phone
(973) 379-4377
NPI assigned
May 1, 2007
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40QA00204700 NJ Primary

Addresses

Primary practice location

43 Elmwood PL
Short Hills, NJ 07078-3320

Mailing address

43 Elmwood PL
Short Hills, NJ 07078-3320
Phone (973) 379-4377

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers School of Dental Medicine CurrentSince Jan 1, 2015 Accepting new patients
Rutgers School of Dental Medicine CurrentSince Jan 1, 2015 Accepting new patients

Locations

110 Bergen St
#D718
Newark, NJ 07103
Phone (973) 972-4242

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306067855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 ELMWOOD PL",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070783320",
            "telephone_number": "973-379-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 ELMWOOD PL",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070783320",
            "telephone_number": "973-379-4377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMOND",
        "first_name": "SUSAN",
        "middle_name": "LEIGH",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00204700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Short Hills, NJ

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.