Individual provider Active NPI

Susan Ukpeyene Ogwu

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1386493286
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
9512 Harford Rd Ste 3
Baltimore, MD 21234-3127
Phone
(410) 882-3010
NPI assigned
May 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X TX Primary

Addresses

Primary practice location

9512 Harford Rd Ste 3
Baltimore, MD 21234-3127

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (866) 370-8206

Other practice location 1

2360 W Camp Wisdom Rd Ste 140
Grand Prairie, TX 75052-2216
Phone (469) 460-6683

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240724002763 TX Practitioner - Physical Therapist in Private Practice 6901342120 Reassigns benefits to 2 organizations
I20250604002172 MD Practitioner - Physical Therapist in Private Practice 6901342120 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Physical Therapy of Texas LLCGroup PAC ID 0547583809, 359 clinicians
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

2250 E Palm Valley Blvd
Suite 205
Round Rock, TX 78665-4534
Phone (512) 975-7199

9512 Harford Rd
Suite 3
Baltimore, MD 21234-3127
Phone (410) 882-3010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Jul 7, 2025 Accepting new patients
Ideal Physical Therapy of Texas LLC CurrentSince Jun 10, 2024 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Jul 7, 2025 Accepting new patients
Ideal Physical Therapy of Texas LLC Physical Therapist CurrentSince Jun 10, 2024 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2001 Butterfield Rd
Ste 1600
Downers Grove, IL 60515

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

9512 Harford Rd
Ste 3
Parkville, MD 21234
Phone (410) 882-3010

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

17051 Dallas Pkwy
Ste 450
Addison, TX 75001
Phone (214) 272-8561

4100 Fairway Dr
Ste 400
Carrollton, TX 75010
Phone (972) 394-3325

379 E FM 1382
Ste 100
Cedar Hill, TX 75104
Phone (972) 460-4490

106 N Denton Tap Rd
Ste 220
Coppell, TX 75019
Phone (469) 528-6437

607 S Cedar Ridge Dr
Unit 102
Duncanville, TX 75137
Phone (214) 742-8560

2600 W 7th St
Ste 137
Fort Worth, TX 76107
Phone (682) 233-6462

1215 W Pioneer Pkwy
Ste 200
Grand Prairie, TX 75051
Phone (972) 400-4752

2360 W Camp Wisdom Rd
Ste 140
Grand Prairie, TX 75052
Phone (469) 460-6683

6420 N MacArthur Blvd
Ste 130
Irving, TX 75039
Phone (972) 402-8300

2250 E Palm Valley Blvd
Ste 205
Round Rock, TX 78665
Phone (512) 975-7199

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1386493286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9512 HARFORD RD STE 3",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212343127",
            "telephone_number": "410-882-3010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2360 W Camp Wisdom Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "750522216",
            "country_code": "US",
            "telephone_number": "469-460-6683",
            "fax_number": "469-348-2396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGWU",
        "first_name": "SUSAN",
        "middle_name": "UKPEYENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.