Active NPI
Stephanie Suesse, PT
- Physical Therapist
- Glen Burnie, MD
National Provider Identifier
1780265868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 17926
- Practice address
- 1600 Crain Hwy S Ste 302
Glen Burnie, MD 21061-6445 - Phone
- (410) 768-1213
- Fax
- (410) 768-1203
- NPI assigned
- Apr 20, 2021
- 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 | 17926 | MD | Primary |
Addresses
Primary practice location
1600 Crain Hwy S Ste 302
Glen Burnie, MD 21061-6445
Mailing address
350 New Fidelity CT
Garner, NC 27529-2665
Phone (919) 258-2714
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17926 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619481600000",
"number": "1780265868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 NEW FIDELITY CT",
"city": "GARNER",
"state": "NC",
"postal_code": "275292665",
"telephone_number": "919-258-2714",
"fax_number": "410-648-4878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 CRAIN HWY S STE 302",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210616445",
"telephone_number": "410-768-1213",
"fax_number": "410-768-1203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUESSE",
"first_name": "STEPHANIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-20",
"last_updated": "2021-04-27",
"certification_date": "2021-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "17926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Burnie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.