Individual provider Active NPI

Susan H. Hewlett, RPT

  • Physical Therapist
  • Lucedale, MS
National Provider Identifier
1356536742
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6221 Issued in MS
Practice address
2210 Mill Street Ext Ste B
Lucedale, MS 39452-6079
Phone
(601) 947-9005
Fax
(601) 947-9007
NPI assigned
Sep 10, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT006718 FL
Physical Therapist 225100000X PT6221 MS Primary

Addresses

Primary practice location

2210 Mill Street Ext Ste B
Lucedale, MS 39452-6079

Mailing address

251 Johnston St SE Ste 200
Decatur, AL 35601-2515
Phone (256) 350-1764

Other practice location 1

3144 NW 114th Ave
Coral Springs, FL 33065-3106
Phone (954) 753-5262

Other practice location 2

433 Main St
Leakesville, MS 39451-6502
Phone (601) 394-4545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170929000339 MS Practitioner - Physical Therapist in Private Practice 5496020539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Encore Rehabilitation, IncGroup PAC ID 3577462126, 182 clinicians

Practice addresses (Care Compare)

433 Main St
Leakesville, MS 39451-6502
Phone (601) 394-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT006718FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation, Inc. Physical Therapist CurrentSince Jul 17, 2017 Accepting new patients
Encore Rehabilitation, Inc. Physical Therapist CurrentSince Jul 17, 2017 Accepting new patients

Locations

251 Johnston St SE
Ste 300
Decatur, AL 35601
Phone (256) 340-9708

433 Main St
Leakesville, MS 39451
Phone (601) 394-4545

2210 Mill Street Ext
Ste B
Lucedale, MS 39452
Phone (601) 947-9005

5136 Main St
Lucedale, MS 39452
Phone (601) 947-9005

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356536742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 JOHNSTON ST SE STE 200",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012515",
            "telephone_number": "256-350-1764",
            "fax_number": "256-355-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 MILL STREET EXT STE B",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394526079",
            "telephone_number": "601-947-9005",
            "fax_number": "601-947-9007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3144 NW 114th Ave",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330653106",
            "country_code": "US",
            "telephone_number": "954-753-5262",
            "fax_number": "954-752-8431",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "433 Main St",
            "address_purpose": "LOCATION",
            "city": "Leakesville",
            "state": "MS",
            "postal_code": "394516502",
            "country_code": "US",
            "telephone_number": "601-394-4545",
            "fax_number": "601-394-4546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEWLETT",
        "first_name": "SUSAN",
        "middle_name": "H.",
        "name_prefix": "Mrs.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT006718",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT6221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lucedale, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.