Individual provider Active NPI

Susan Dialogo Salob-Abiog, P.T.

  • Physical Therapist
  • Colorado Springs, CO
National Provider Identifier
1689814220
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL0013631 Issued in CO
Practice address
685 Citadel Dr E Ste 669
Colorado Springs, CO 80909-5453
Phone
(719) 597-6241
Fax
(719) 698-9944
NPI assigned
Feb 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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 PTL0013631 CO Primary

Addresses

Primary practice location

685 Citadel Dr E Ste 669
Colorado Springs, CO 80909-5453

Mailing address

685 Citadel Dr E Ste 669
Colorado Springs, CO 80909-5453
Phone (719) 597-6241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220831000441 CO Practitioner - Physical Therapist in Private Practice 2062895675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTL0013631COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Colorado Pro Health Rehab-Kids & Adults LLC Physical Therapist CurrentSince May 1, 2022 Accepting new patients

Locations

685 Citadel Dr E
Ste 669
Colorado Springs, CO 80909
Phone (719) 597-6241

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

NPI Registry JSON

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1689814220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 CITADEL DR E STE 669",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095453",
            "telephone_number": "719-597-6241",
            "fax_number": "719-698-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 CITADEL DR E STE 669",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809095453",
            "telephone_number": "719-597-6241",
            "fax_number": "719-698-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALOB-ABIOG",
        "first_name": "SUSAN",
        "middle_name": "DIALOGO",
        "name_prefix": "Miss",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-23",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL0013631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.