Individual provider Active NPI

Susan Jenkins Hoyle, P.T.

  • Physical Therapist
  • Olive Branch, MS
National Provider Identifier
1740378140
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0682 Issued in MS
Practice address
4850 Goodman Rd Ste 110
Olive Branch, MS 38654
Phone
(662) 349-6712
Fax
(662) 349-6782
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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 PT0682 MS Primary

Addresses

Primary practice location

4850 Goodman Rd Ste 110
Olive Branch, MS 38654

Mailing address

4850 Goodman Rd Ste 110
Olive Branch, MS 38654-7906
Phone (662) 349-6712

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
PT0682MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Physical Therapy, Inc Physical Therapist CurrentSince Oct 1, 2001 Accepting new patients

Locations

4850 Goodman Rd
Ste 204
Olive Branch, MS 38654
Phone (662) 349-6712

4850 Goodman Rd
Ste 110
Olive Branch, MS 38654
Phone (662) 349-6712

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1740378140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 GOODMAN RD STE 110",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547906",
            "telephone_number": "662-349-6712",
            "fax_number": "662-349-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 GOODMAN RD STE 110",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "38654",
            "telephone_number": "662-349-6712",
            "fax_number": "662-349-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOYLE",
        "first_name": "SUSAN",
        "middle_name": "JENKINS",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT0682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olive Branch, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.