Active NPI
Susan Shrode, P.T.
- Physical Therapist
- Washburn, WI
National Provider Identifier
1306276373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12227-24
- Practice address
- 706 Bratley Dr
Washburn, WI 54891-1143 - Phone
- (715) 373-5621
- NPI assigned
- Nov 12, 2013
- 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 | 12227-24 | WI | Primary |
Addresses
Primary practice location
706 Bratley Dr
Washburn, WI 54891-1143
Mailing address
706 Bratley Dr
Washburn, WI 54891-1143
Phone (715) 373-5621
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12227-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384214400000",
"number": "1306276373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "706 BRATLEY DR",
"city": "WASHBURN",
"state": "WI",
"postal_code": "548911143",
"telephone_number": "715-373-5621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "706 BRATLEY DR",
"city": "WASHBURN",
"state": "WI",
"postal_code": "548911143",
"telephone_number": "715-373-5621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHRODE",
"first_name": "SUSAN",
"name_prefix": "Mrs.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-12",
"last_updated": "2013-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "12227-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washburn, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.