Susquehanna Physician Services

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

Legal business name

SUSQUEHANNA PHYSICIAN SERVICES

Practice address

2330 Saint Mary St W Ste 1
Lewisburg, PA 17837-8805

Phone

(570) 522-8637

NPI assigned

Nov 3, 2020

Last updated

Jan 23, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melissa Davis

Title

President

Phone

(570) 326-8544

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1578164943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 SAINT MARY ST W STE 1",
            "city": "LEWISBURG",
            "state": "PA",
            "postal_code": "178378805",
            "telephone_number": "570-522-8637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSQUEHANNA PHYSICIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-326-8544"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Stump-Jones, LPC
• Sun Orthopaedic Group, Inc.
• Sun Surgical Center, LLC
• Allison Rose Supranowicz, PA-C
• Susquehanna Physical Therapy Associates, Inc. (Susquehanna Physical Therapy)
• Susquehanna Valley Hearing Professionals,LLC
• Susquehanna Valley Therapy Group, LLC
• Paul Sutton, M.D.
• Hailey Swartz, COTA/L
• Amelia Ann-Marie Swartzbaugh, CRNP

• Foot Surgery Podiatrist in Lewisburg, PA
• Providers in Lewisburg, PA by specialty
• Foot Surgery Podiatrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.