Active NPI
Susan Seamount Hennessy, M.P.T.
- Physical Therapist
- Redwood City, CA
National Provider Identifier
1649537465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT15042
- Practice address
- 477 Jeter St
Redwood City, CA 94062-2058 - Phone
- (650) 464-0328
- Fax
- (650) 780-9711
- NPI assigned
- Apr 18, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT15042 | CA | Primary |
Addresses
Primary practice location
477 Jeter St
Redwood City, CA 94062-2058
Mailing address
477 Jeter St
Redwood City, CA 94062-2058
Phone (650) 464-0328
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT15042 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374969600000",
"number": "1649537465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "477 JETER ST",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940622058",
"telephone_number": "650-464-0328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "477 JETER ST",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940622058",
"telephone_number": "650-464-0328",
"fax_number": "650-780-9711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENNESSY",
"first_name": "SUSAN",
"middle_name": "SEAMOUNT",
"name_prefix": "Ms.",
"credential": "M.P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-18",
"last_updated": "2013-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT15042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.