Individual provider Active NPI

Susan Marie Burtch, P.T.

  • Physical Therapist
  • Wausau, WI
National Provider Identifier
1427108794
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2445-024 Issued in WI
Practice address
520 N 32ND Ave
Wausau, WI 54401-4701
Phone
(715) 847-2600
Fax
(715) 847-2606
NPI assigned
Jan 11, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 2445-024 WI Primary

Addresses

Primary practice location

520 N 32ND Ave
Wausau, WI 54401-4701

Mailing address

3503 N 80TH Ave
Wausau, WI 54401-9752
Phone (715) 675-4415

Other identifiers 1

IdentifierTypeStateIssuer
40343300MedicaidWI

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

LicenseStateTypeSpecialty
2445-024WIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1427108794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3503 N 80TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544019752",
            "telephone_number": "715-675-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N 32ND AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014701",
            "telephone_number": "715-847-2600",
            "fax_number": "715-847-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTCH",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "2445-024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40343300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wausau, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.