Active NPI
Susan C Millison, PT
- Physical Therapist
- Santa Fe, NM
National Provider Identifier
1689719577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1977
- Practice address
- 4309 Cloud Dance
Santa Fe, NM 87507-2591 - Phone
- (505) 438-2960
- Fax
- (505) 438-2960
- NPI assigned
- Feb 20, 2007
- 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 | 1977 | NM | Primary |
Addresses
Primary practice location
4309 Cloud Dance
Santa Fe, NM 87507-2591
Mailing address
PO Box 517
Arroyo Hondo, NM 87513-0517
Phone (505) 776-1213
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B-3589 | Medicaid | NM |
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 |
|---|---|---|---|
| 1977 | NM | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1689719577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 517",
"city": "ARROYO HONDO",
"state": "NM",
"postal_code": "875130517",
"telephone_number": "505-776-1213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4309 CLOUD DANCE",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875072591",
"telephone_number": "505-438-2960",
"fax_number": "505-438-2960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLISON",
"first_name": "SUSAN",
"middle_name": "C",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "1977",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "B-3589",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.