Susan Amy Speich, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

1164 Issued in ND

Practice address

7119 Maple LN
Horace, ND 58047-4714

Phone

(701) 281-1864

Fax

(701) 281-1924

NPI assigned

Jan 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Abc Pediatric Physical Therapy, LTD.

  • Physical Therapy Clinic/Center
  • Horace, ND
  • NPI 1114074234
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780732883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 WINSLOW CT",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580784041",
            "telephone_number": "701-282-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7119 MAPLE LN",
            "city": "HORACE",
            "state": "ND",
            "postal_code": "580474714",
            "telephone_number": "701-281-1864",
            "fax_number": "701-281-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEICH",
        "first_name": "SUSAN",
        "middle_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "ND",
            "license": "1164",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MN",
            "license": "6605",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51398",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "27585",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Dakota Adult Foster Care LLC
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• Shepherd Homes LLC
• Kristin Sorvig, PT
• Eva Torres, CNA
• True North Home Health, LLC
• Lexi Vogel
• Yellow Rose Digital Therapy

• Pediatric Physical Therapist in Horace, ND
• Providers in Horace, ND by specialty
• Pediatric Physical Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.