Individual provider Active NPI

Rebecca Suckow, PT, DPT

  • Physical Therapist
  • Longmont, CO
National Provider Identifier
1598208258
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0014272 Issued in CO
Practice address
1610 Dry Creek Dr
Longmont, CO 80503
Phone
(720) 494-4750
Fax
(720) 494-4751
NPI assigned
Nov 29, 2016
Last updated
Jun 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0014272 CO Primary

Addresses

Primary practice location

1610 Dry Creek Dr
Longmont, CO 80503

Mailing address

1610 Dry Creek Dr
Longmont, CO 80503-6405
Phone (720) 494-4750

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
0014272COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1598208258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 DRY CREEK DR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805036405",
            "telephone_number": "720-494-4750",
            "fax_number": "720-494-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 DRY CREEK DR",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "80503",
            "telephone_number": "720-494-4750",
            "fax_number": "720-494-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCKOW",
        "first_name": "REBECCA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0014272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; 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.