Active NPI
Susan Irene Lackner, PT
- Physical Therapist
- Lutherville, MD
National Provider Identifier
1386979599
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 22186
- Practice address
- 10753 Falls Rd
Suite 235
Lutherville, MD 21093-4535 - Phone
- (410) 583-2665
- Fax
- (410) 847-3838
- NPI assigned
- Oct 5, 2009
- Sex
- Female
- Sole proprietor
- No
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 | 22186 | MD | Primary |
Addresses
Primary practice location
10753 Falls Rd
Suite 235
Lutherville, MD 21093-4535
Mailing address
10753 Falls Rd
Suite 235
Lutherville, MD 21093-4535
Phone (410) 583-2665
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 |
|---|---|---|---|
| 22186 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254700800000",
"number": "1386979599",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10753 FALLS RD",
"address_2": "SUITE 235",
"city": "LUTHERVILLE",
"state": "MD",
"postal_code": "210934535",
"telephone_number": "410-583-2665",
"fax_number": "410-847-3838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10753 FALLS RD",
"address_2": "SUITE 235",
"city": "LUTHERVILLE",
"state": "MD",
"postal_code": "210934535",
"telephone_number": "410-583-2665",
"fax_number": "410-847-3838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACKNER",
"first_name": "SUSAN",
"middle_name": "IRENE",
"name_prefix": "Miss",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-05",
"last_updated": "2009-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "22186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lutherville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.