Active NPI
Susan Dooley Conaway
- Physical Therapy Assistant
- Evansville, WI
National Provider Identifier
1366744369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1596-019
- Practice address
- 470 Garfield Ave
Evansville, WI 53536-1014 - Phone
- (608) 882-6557
- NPI assigned
- Nov 23, 2010
- 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 Therapy Assistant | 225200000X | 1596-019 | WI | Primary |
Addresses
Primary practice location
470 Garfield Ave
Evansville, WI 53536-1014
Mailing address
248 Ba Wood LN
Janesville, WI 53545-0705
Other names 1
- Miss Susan Mary Dooley
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 |
|---|---|---|---|
| 1596-019 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290470400000",
"number": "1366744369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "248 BA WOOD LN",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535450705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 GARFIELD AVE",
"city": "EVANSVILLE",
"state": "WI",
"postal_code": "535361014",
"telephone_number": "608-882-6557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONAWAY",
"first_name": "SUSAN",
"middle_name": "DOOLEY",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-23",
"last_updated": "2010-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "1596-019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "DOOLEY",
"middle_name": "MARY",
"prefix": "MISS",
"credential": "PTA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Evansville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.