Active NPI
Susan Cool
- Physical Therapist
- Eau Claire, WI
National Provider Identifier
1548433923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2081-24
- Practice address
- 3656 Mall Dr
Eau Claire, WI 54701-7634 - Phone
- (715) 552-1036
- Fax
- (715) 552-4567
- NPI assigned
- Apr 8, 2008
- 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 | 2081-24 | WI | Primary |
Addresses
Primary practice location
3656 Mall Dr
Eau Claire, WI 54701-7634
Mailing address
3656 Mall Dr
Eau Claire, WI 54701-7634
Phone (715) 552-1036
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 390848401050 | Other | WI | BLUE CROSS |
| 11014100 | Medicaid | WI | |
| 11014110 | Medicaid | WI | |
| 2081-24 | Other | WI | LICENSE NUMBER |
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 |
|---|---|---|---|
| 2081 | WI | MD | Optometrist |
| 2081-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306195200000",
"number": "1548433923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3656 MALL DR",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547017634",
"telephone_number": "715-552-1036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3656 MALL DR",
"city": "EAU CLAIRE",
"state": "WI",
"postal_code": "547017634",
"telephone_number": "715-552-1036",
"fax_number": "715-552-4567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOL",
"first_name": "SUSAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-08",
"last_updated": "2011-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "2081-24",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "390848401050",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11014100",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11014110",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "2081-24",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eau Claire, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.