Individual provider Active NPI

Sue Daniels O'Driscoll, PT, DPT

  • Physical Therapist
  • Miami, FL
National Provider Identifier
1710220165
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT38030 Issued in FL
Practice address
12448 SW 127TH Ave FL 2
Miami, FL 33186-6596
Phone
(704) 737-3182
Fax
(617) 383-6520
NPI assigned
Apr 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X
Physical Therapist 225100000X PT38030 FL Primary

Addresses

Primary practice location

12448 SW 127TH Ave FL 2
Miami, FL 33186-6596

Mailing address

555 Amory St
Jamaica Plain, MA 02130-2652
Phone (617) 383-6522

Other names 1

  • Sue Daniels Smith Former name

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

LicenseStateTypeSpecialty
PT38030FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1710220165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 AMORY ST",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021302652",
            "telephone_number": "617-383-6522",
            "fax_number": "617-383-6520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12448 SW 127TH AVE FL 2",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331866596",
            "telephone_number": "704-737-3182",
            "fax_number": "617-383-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DRISCOLL",
        "first_name": "SUE",
        "middle_name": "DANIELS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-04",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT38030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUE",
            "last_name": "SMITH",
            "middle_name": "DANIELS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.