Colleen Heather Kussard, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

036375 Issued in NY

Practice address

1715 Castle Gardens Rd
Vestal, NY 13850-1175

Phone

(607) 484-5079

NPI assigned

May 28, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Colleen Heather Davis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pivot Physical Therapy of Pennsylvania, LLC

  • Physical Therapist
  • South Abington Township, PA
  • NPI 1881132488
  NPD (past)

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456790400000",
    "number": "1548607831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT",
            "address_2": "SUITE 105",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-467-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 CASTLE GARDENS RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138501175",
            "telephone_number": "607-484-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSSARD",
        "first_name": "COLLEEN",
        "middle_name": "HEATHER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2016-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "036375",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT022692",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "DAVIS",
            "middle_name": "HEATHER",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Colleen Kramer, PA
• Brett Krummenacker
• Amanda Krupka, MD
• Manish Kumar, M.D.
• Baris Mehmet Kural, M.D.
• Elizabeth Labarre, NP
• Kaylyn Blaire Labarre, PT
• Justin Ladue, LPN
• Lalor Creekside Dental
• Robert Andrew Lalor, M.D.

• Physical Therapist in Vestal, NY
• Providers in Vestal, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.