Individual provider Active NPI

Philip Martin Suess, DPT

  • Orthopedic Physical Therapist
  • Waycross, GA
National Provider Identifier
1760629711
Registry record updated Jan 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT009022 Issued in GA
Practice address
401 Preston St
Waycross, GA 31501-5248
Phone
(912) 283-7402
NPI assigned
Jan 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT009022 GA Primary

Addresses

Primary practice location

401 Preston St
Waycross, GA 31501-5248

Mailing address

401 Preston St
Waycross, GA 31501-5248
Phone (912) 283-7402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150422002321 GA Practitioner - Physical Therapist in Private Practice 5698093615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

401 Preston St
Waycross, GA 31501-5248
Phone (912) 283-7342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ware County Physical Therapy, Inc. CurrentSince Feb 24, 2015 Accepting new patients

Locations

401 Preston St
Waycross, GA 31501
Phone (912) 283-7342

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": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231804800000",
    "number": "1760629711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 PRESTON ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015248",
            "telephone_number": "912-283-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PRESTON ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315015248",
            "telephone_number": "912-283-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUESS",
        "first_name": "PHILIP",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-13",
        "last_updated": "2009-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT009022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.