Individual provider Active NPI

Susan Harris Gill, PT

  • Physical Therapist
  • Virginia Beach, VA
National Provider Identifier
1629853700
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305003667 Issued in VA
Practice address
1164 Millers LN Ste a
Virginia Beach, VA 23451-5716
Phone
(757) 962-3567
Fax
(757) 961-4824
NPI assigned
Aug 28, 2023
Last updated
Aug 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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 2305003667 VA Primary

Addresses

Primary practice location

1164 Millers LN Ste a
Virginia Beach, VA 23451-5716

Mailing address

1164 Millers LN # a
Virginia Beach, VA 23451-5716
Phone (757) 962-3567

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2305003667VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pin-People in Need CurrentSince Oct 22, 2023 Accepting new patients
Pin Ministry PastSince Sep 5, 2023 Accepting new patients

Locations

1164 Millers Ln
#A
Virginia Beach, VA 23451
Phone (757) 962-3567

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": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1629853700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1164 MILLERS LN # A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234515716",
            "telephone_number": "757-962-3567",
            "fax_number": "757-961-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1164 MILLERS LN STE A",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234515716",
            "telephone_number": "757-962-3567",
            "fax_number": "757-961-4824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "SUSAN",
        "middle_name": "HARRIS",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305003667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.