Active NPI
Susan Marie Glover, PT
- Physical Therapist
- Niceville, FL
National Provider Identifier
1720061971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 32703
- Practice address
- 1500 White Point Rd
Niceville, FL 32578-4249 - Phone
- (850) 896-5592
- Fax
- (850) 897-0501
- NPI assigned
- Nov 22, 2005
- Sex
- Female
- Sole proprietor
- No
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 | 32703 | FL | Primary |
Addresses
Primary practice location
1500 White Point Rd
Niceville, FL 32578-4249
Mailing address
1214 Tennessee Ave
Lynn Haven, FL 32444-2265
Phone (765) 617-0042
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | HR@selectrehab.com | Direct | |
| CONNECT URL | manor.blue.water.bay@selectrehab.com | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 32703 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577750400000",
"number": "1720061971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1214 TENNESSEE AVE",
"city": "LYNN HAVEN",
"state": "FL",
"postal_code": "324442265",
"telephone_number": "765-617-0042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 WHITE POINT RD",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325784249",
"telephone_number": "850-896-5592",
"fax_number": "850-897-0501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLOVER",
"first_name": "SUSAN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-22",
"last_updated": "2019-12-31",
"certification_date": "2019-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "32703",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "HR@selectrehab.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1500 White Point Rd",
"city": "Niceville",
"state": "FL",
"country_code": "US",
"postal_code": "325784249",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "manor.blue.water.bay@selectrehab.com",
"affiliation": "N",
"endpointDescription": "Rehabilitation Department",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1500 White Point Rd",
"city": "Niceville",
"state": "FL",
"country_code": "US",
"postal_code": "325784249",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Niceville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.