Individual provider Active NPI

Susan Judyth Lamberson, MS, PT

  • Physical Therapist
  • Pleasanton, CA
National Provider Identifier
1659684355
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT25165 Issued in CA
Practice address
4626 Willow Road
Suite 200
Pleasanton, CA 94588-8564
Phone
(925) 463-0470
Fax
(925) 463-0473
NPI assigned
Jul 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT25165 CA Primary
Physical Therapist 225100000X PT 60149183 WA

Addresses

Primary practice location

4626 Willow Road
Suite 200
Pleasanton, CA 94588-8564

Mailing address

4626 Willow Rd
Suite 200
Pleasanton, CA 94588-8517
Phone (925) 463-0470

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
10554SCMDMental Health Counselor
25165CAMDPharmacist
PT25165CAMDPhysical Therapist
PT 60149183WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Physical Therapy and Sports Medicine, Inc. CurrentSince Feb 9, 2022 Accepting new patients

Locations

141 Atrium Way
Columbia, SC 29223
Phone (803) 788-8484

3040 N Highway 17
Ste A
Mt Pleasant, SC 29466
Phone (843) 388-7667

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1659684355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 WILLOW RD",
            "address_2": "SUITE 200",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888517",
            "telephone_number": "925-463-0470",
            "fax_number": "925-463-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4626 WILLOW ROAD",
            "address_2": "SUITE 200",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945888564",
            "telephone_number": "925-463-0470",
            "fax_number": "925-463-0473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBERSON",
        "first_name": "SUSAN",
        "middle_name": "JUDYTH",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT25165",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT 60149183",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.