Active NPI
Suzanna Wilkerson, PT
- Physical Therapist
- Lebanon, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2018023366
- Practice address
- 860 Lynn St
Lebanon, MO 65536-3810 - Phone
- (417) 334-8337
- Fax
- (417) 532-2067
- NPI assigned
- Apr 26, 2022
- Last updated
- Oct 10, 2023
- 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 | 2018023366 | MO | Primary |
Addresses
Primary practice location
860 Lynn St
Lebanon, MO 65536-3810
Mailing address
440 E Tampa St
Springfield, MO 65806-1131
Phone (417) 851-1551
Other names 1
- Suzanna Thorne
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advocates for a Healthy Community, Inc | Current | Accepting new patients | |
| Advocates for a Healthy Community Inc | Current | Accepting new patients | |
| Advocates for a Healthy Community, Inc. | Past | Accepting new patients |
Locations
860 Lynn St
Lebanon, MO 65536
Phone (417) 334-8337
440 E Tampa St
Springfield, MO 65806
Phone (417) 831-0191
Interoperability endpoints
- suzanna.thorne.p1@direct.jordanvalley.nextgenshare.com
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Jordan Valley Community Health Center
- Federally Qualified Health Center (FQHC)
- Springfield, MO
- NPI 1558303057
-
dba Jordan Valley Community Health Center
- Federally Qualified Health Center (FQHC)
- Buffalo, MO
- NPI 1750179610
-
dba Jordan Valley Community Health Center
- Federally Qualified Health Center (FQHC)
- Springfield, MO
- NPI 1861590861
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1780328724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 E TAMPA ST",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658061131",
"telephone_number": "417-851-1551",
"fax_number": "417-832-8275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 LYNN ST",
"city": "LEBANON",
"state": "MO",
"postal_code": "655363810",
"telephone_number": "417-334-8337",
"fax_number": "417-532-2067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKERSON",
"first_name": "SUZANNA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-26",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2018023366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUZANNA",
"last_name": "THORNE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Lebanon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.