Active NPI
Susan Rand Phillips, PT
- Physical Therapist
- Winthrop, ME
National Provider Identifier
1699736330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT9400
- Practice address
- 18A High St
Winthrop, ME 04364 - Phone
- (207) 377-9400
- Fax
- (207) 377-3385
- NPI assigned
- Mar 31, 2006
- 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 | PT9400 | ME | Primary |
Addresses
Primary practice location
18A High St
Winthrop, ME 04364
Mailing address
18A High St
Winthrop, ME 04364
Phone (207) 377-9400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004625 | Other | ME | BC/BS |
| 123230000 | Medicaid | ME |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 112 | ME | MD | Acupuncturist |
| PT9400 | ME | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339027200000",
"number": "1699736330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18A HIGH ST",
"city": "WINTHROP",
"state": "ME",
"postal_code": "04364",
"telephone_number": "207-377-9400",
"fax_number": "207-377-3385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18A HIGH ST",
"city": "WINTHROP",
"state": "ME",
"postal_code": "04364",
"telephone_number": "207-377-9400",
"fax_number": "207-377-3385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "SUSAN",
"middle_name": "RAND",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-31",
"last_updated": "2012-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT9400",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "004625",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "123230000",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winthrop, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.