Susan Lynn Perigo, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

06000103A Issued in IN

Practice address

RR 2 Box 208
Glenburn Road
Linton, IN 47441-9664

Phone

(812) 847-9675

Fax

(812) 847-4708

NPI assigned

Aug 5, 2008

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 5, 2008.

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1396901716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 208",
            "address_2": "GLENBURN ROAD",
            "city": "LINTON",
            "state": "IN",
            "postal_code": "474419664",
            "telephone_number": "812-847-9675",
            "fax_number": "812-847-4708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 208",
            "address_2": "GLENBURN ROAD",
            "city": "LINTON",
            "state": "IN",
            "postal_code": "474419664",
            "telephone_number": "812-847-9675",
            "fax_number": "812-847-4708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERIGO",
        "first_name": "SUSAN",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06000103A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Linton, IN
• Physical Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.