Individual provider Active NPI

Susan D Abbott, PT

  • Physical Therapist
  • Thermopolis, WY
National Provider Identifier
1629274303
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-319 Issued in WY
Practice address
148 E Arapahoe St
Thermopolis, WY 82443-2402
Phone
(307) 864-2146
NPI assigned
Jun 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT-319 WY Primary

Addresses

Primary practice location

148 E Arapahoe St
Thermopolis, WY 82443-2402

Mailing address

PO Box 790
Thermopolis, WY 82443-0790

Other identifiers 1

IdentifierTypeStateIssuer
311449OtherWYBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051117000346 WY Practitioner - Physical Therapist in Private Practice 7012936156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William H and Carrie Gottsche FoundationGroup PAC ID 5092606293, 73 clinicians

Practice addresses (Care Compare)

148 E Arapahoe St
Thermopolis, WY 82443-2402
Phone (307) 864-2146

406 S 4TH St
Basin, WY 82401-9500
Phone (307) 568-9399

501 S 23Rd St
Worland, WY 82401-3704
Phone (307) 347-2535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-319WYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Pain Management of Wyoming, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629274303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "city": "THERMOPOLIS",
            "state": "WY",
            "postal_code": "824430790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 E ARAPAHOE ST",
            "city": "THERMOPOLIS",
            "state": "WY",
            "postal_code": "824432402",
            "telephone_number": "307-864-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBOTT",
        "first_name": "SUSAN",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT-319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "311449",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thermopolis, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.