Active NPI
Susie Phillips
- Physical Therapist
- Oklahoma City, OK
National Provider Identifier
1750652475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1397
- Practice address
- 3030 NW Expressway
Suite 809
Oklahoma City, OK 73112-5474 - Phone
- (866) 848-8813
- NPI assigned
- Jan 26, 2012
- 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 | 1397 | OK | Primary |
Addresses
Primary practice location
3030 NW Expressway
Suite 809
Oklahoma City, OK 73112-5474
Mailing address
1649 Saratoga Way
Edmond, OK 73003-3552
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 |
|---|---|---|---|
| 1397 | OK | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327536000000",
"number": "1750652475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1649 SARATOGA WAY",
"city": "EDMOND",
"state": "OK",
"postal_code": "730033552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 NW EXPRESSWAY",
"address_2": "SUITE 809",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731125474",
"telephone_number": "866-848-8813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "SUSIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-26",
"last_updated": "2012-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "1397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.