Active NPI
Suzanne Maureen Goshorn, PTA
- Physical Therapy Assistant
- Harlan, IA
National Provider Identifier
1447376199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 00813
- Practice address
- 1213 Garfield Ave
Harlan, IA 51537-2057 - Phone
- (712) 755-4342
- NPI assigned
- Mar 22, 2007
- 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 | 00813 | IA | Primary |
Addresses
Primary practice location
1213 Garfield Ave
Harlan, IA 51537-2057
Mailing address
834 Linden Rd
Harlan, IA 51537-5406
Phone (712) 235-2078
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 |
|---|---|---|---|
| 00813 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447376199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "834 LINDEN RD",
"city": "HARLAN",
"state": "IA",
"postal_code": "515375406",
"telephone_number": "712-235-2078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1213 GARFIELD AVE",
"city": "HARLAN",
"state": "IA",
"postal_code": "515372057",
"telephone_number": "712-755-4342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOSHORN",
"first_name": "SUZANNE",
"middle_name": "MAUREEN",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IA",
"license": "00813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harlan, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.