Susan Carol Lazenby

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501002541 Issued in MI

Practice address

7445 Allen Rd
Allen Park, MI 48101-1963

Phone

(313) 389-5600

NPI assigned

Feb 27, 2018

Last updated

Feb 27, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD (past)

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1679074462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7445 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011963",
            "telephone_number": "313-389-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7445 ALLEN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011963",
            "telephone_number": "313-389-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZENBY",
        "first_name": "SUSAN",
        "middle_name": "CAROL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501002541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38-1357020",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Peter Kronk, PH.D.
• M. Redwan Kubaisi, MD
• Jennifer Laduke
• Ronald Lambert, P.A.
• Lawrence a Hansen MD PLC
• Byung Jae Jack Lee, DMD
• Cheng Chong Lee, MD
• Stacey Lee, DDS
• Tracy Lynn Leeman, LMT
• Lincoln Medical Equipment, Inc

• Physical Therapist in Allen Park, MI
• Providers in Allen Park, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; 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.