Active NPI
Susan Jean Brott, P.T.
- Physical Therapist
- Reedsburg, WI
National Provider Identifier
1336330331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2428-024
- Practice address
- 2000 N Dewey Ave
Reedsburg, WI 53959-1049 - Phone
- (608) 524-6487
- Fax
- (608) 524-6196
- NPI assigned
- Aug 5, 2007
- 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 | 2428-024 | WI | Primary |
Addresses
Primary practice location
2000 N Dewey Ave
Reedsburg, WI 53959-1049
Mailing address
2000 N Dewey Ave
Reedsburg, WI 53959-1049
Phone (608) 524-6487
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 402440000013720 | Medicaid | WI |
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 |
|---|---|---|---|
| 2428-024 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186272000000",
"number": "1336330331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 N DEWEY AVE",
"city": "REEDSBURG",
"state": "WI",
"postal_code": "539591049",
"telephone_number": "608-524-6487",
"fax_number": "608-524-6196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 N DEWEY AVE",
"city": "REEDSBURG",
"state": "WI",
"postal_code": "539591049",
"telephone_number": "608-524-6487",
"fax_number": "608-524-6196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROTT",
"first_name": "SUSAN",
"middle_name": "JEAN",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-05",
"last_updated": "2007-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "2428-024",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "402440000013720",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reedsburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.