Susan Yvonne Pelletier

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

101300 Issued in TX

Practice address

1600 Central Drive
Suite 157
Bedford, TX 76022

Phone

(817) 267-0909

Fax

(817) 283-1868

NPI assigned

Dec 9, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Susan Yvonne Shipman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Susan Y Pelletier

  • Prosthetic/Orthotic Supplier
  • Bedford, TX
  • NPI 1821022088
  NPD (past) Authorized official
• Brace Center LLC

  • Durable Medical Equipment & Medical Supplies
  • Bedford, TX
  • NPI 1417369364
  NPD (past)

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386547200000",
    "number": "1629409198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CENTRAL DRIVE",
            "address_2": "SUITE 157",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "76022",
            "telephone_number": "817-267-0909",
            "fax_number": "817-283-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CENTRAL DRIVE",
            "address_2": "SUITE 157",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "76022",
            "telephone_number": "817-267-0909",
            "fax_number": "817-283-1868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "SUSAN",
        "middle_name": "YVONNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-09",
        "last_updated": "2013-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "101300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SHIPMAN",
            "middle_name": "YVONNE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carolina Paz, PT, DPT
• Amy Pchinow, PTA
• Julie L Pearson, PA
• Pediatric Smiles P.a.
• Jeff Peebles, MD
• Angelica Pena, PTA
• Douglas Pena
• Blanche Penaredondo, LPC-ASSOCIATE
• Lisa Perez, BA
• Perla Dental of Bedford

• Durable Medical Equipment & Medical Supplies in Bedford, TX
• Providers in Bedford, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; 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.