Active NPI
Susan Sivola, PT
- Physical Therapist
- Des Moines, IA
National Provider Identifier
1790108827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00970
- Practice address
- 4725 Merle Hay Rd Ste 107
Des Moines, IA 50322-1983 - Phone
- (515) 331-3191
- NPI assigned
- Jan 24, 2014
- 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 | 00970 | IA | Primary |
Addresses
Primary practice location
4725 Merle Hay Rd Ste 107
Des Moines, IA 50322-1983
Mailing address
4725 Merle Hay Rd Ste 107
Des Moines, IA 50322-1983
Phone (515) 331-3191
Other names 1
- Susan Payne
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 |
|---|---|---|---|
| 00970 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1390521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390521600000",
"number": "1790108827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4725 MERLE HAY RD STE 107",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503221983",
"telephone_number": "515-331-3191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4725 MERLE HAY RD STE 107",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503221983",
"telephone_number": "515-331-3191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIVOLA",
"first_name": "SUSAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-24",
"last_updated": "2014-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "00970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "PAYNE",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.