Individual provider Active NPI

Susanne Marie Simmerman, P.T., SC.D., O.C.S.

  • Physical Therapist
  • Cleburne, TX
National Provider Identifier
1477527612
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
137901 Issued in TX
Practice address
1014 N Nolan River Rd
Cleburne, TX 76033-7925
Phone
(817) 641-8617
Fax
(817) 645-8620
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 137901 TX Primary
Orthopedic Physical Therapist 2251X0800X 137901 TX

Addresses

Primary practice location

1014 N Nolan River Rd
Cleburne, TX 76033-7925

Mailing address

1014 N Nolan River Rd
Cleburne, TX 76033-7925
Phone (817) 641-8617

Other identifiers 3

IdentifierTypeStateIssuer
650003053OtherTXRAILROAD PIN
80236TOtherTXBLUE CROSS BLUE SHIELD OF TEXAS
140989801MedicaidTX

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
137901TXMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Huguley, Inc. Past Accepting new patients

Organizations & group practices 1

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285113600000",
    "number": "1477527612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 N NOLAN RIVER RD",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337925",
            "telephone_number": "817-641-8617",
            "fax_number": "817-641-8620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 N NOLAN RIVER RD",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760337925",
            "telephone_number": "817-641-8617",
            "fax_number": "817-645-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMERMAN",
        "first_name": "SUSANNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "P.T., SC.D., O.C.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2010-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "137901",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TX",
            "license": "137901",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PIN",
            "identifier": "650003053",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF TEXAS",
            "identifier": "80236T",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140989801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.