Active NPI
Susan Jackson Heikkinen
- Physical Therapist
- Pace, FL
National Provider Identifier
1316751936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT11670
- Practice address
- 3650 Berryhill Rd Ste B5
Pace, FL 32571-8321 - Phone
- (860) 995-1364
- Fax
- (850) 995-4457
- NPI assigned
- Feb 4, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 | PT11670 | FL | Primary |
Addresses
Primary practice location
3650 Berryhill Rd Ste B5
Pace, FL 32571-8321
Mailing address
5278 Richardson St
Milton, FL 32570-5046
Phone (850) 797-3824
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 |
|---|---|---|---|
| PT11670 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739318400000",
"number": "1316751936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5278 RICHARDSON ST",
"city": "MILTON",
"state": "FL",
"postal_code": "325705046",
"telephone_number": "850-797-3824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3650 BERRYHILL RD STE B5",
"city": "PACE",
"state": "FL",
"postal_code": "325718321",
"telephone_number": "860-995-1364",
"fax_number": "850-995-4457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEIKKINEN",
"first_name": "SUSAN",
"middle_name": "JACKSON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-04",
"last_updated": "2025-02-12",
"certification_date": "2025-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT11670",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pace, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.