Individual provider Active NPI

Suzanne V Dunkle, P.T.

  • Physical Therapist
  • Woodstock, GA
National Provider Identifier
1689779225
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT005185 Issued in GA
Practice address
4595 Towne Lake Pkwy # 300/240
Woodstock, GA 30189-5514
Phone
(770) 592-3386
Fax
(770) 592-3387
NPI assigned
Sep 14, 2006
Last updated
Mar 3, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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 PT005185 GA Primary

Addresses

Primary practice location

4595 Towne Lake Pkwy # 300/240
Woodstock, GA 30189-5514

Mailing address

4595 Towne Lake Pkwy # 300/240
Woodstock, GA 30189-5514
Phone (770) 592-3386

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

State licenses

LicenseStateTypeSpecialty
PT005185GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1689779225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4595 TOWNE LAKE PKWY # 300/240",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895514",
            "telephone_number": "770-592-3386",
            "fax_number": "770-592-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4595 TOWNE LAKE PKWY # 300/240",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895514",
            "telephone_number": "770-592-3386",
            "fax_number": "770-592-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNKLE",
        "first_name": "SUZANNE",
        "middle_name": "V",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT005185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2008; 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.