NPIMap

Organization Active NPI

John J Susan Lpta LLC

  • Physical Therapy Assistant
  • Debary, FL
National Provider Identifier
1790924462
Registry record updated Mar 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 15708 Issued in FL
Legal business name
JOHN J SUSAN LPTA LLC
Practice address
147 Homestead Ave
Debary, FL 32713-3875
Phone
(386) 668-1156
Fax
(386) 668-1156
NPI assigned
Feb 19, 2009
Last updated
Mar 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2009

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

Authorized official

Name
Mr. John J Susan, LPTANPI 1174785778
Title
Owner/Manager
Phone
(386) 668-1156

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 15708 FL Primary

Addresses

Primary practice location

147 Homestead Ave
Debary, FL 32713-3875

Mailing address

PO Box 530241
Debary, FL 32753-0241
Phone (386) 668-1156

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1235001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237248000000",
    "number": "1790924462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530241",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327530241",
            "telephone_number": "386-668-1156",
            "fax_number": "386-668-1156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 HOMESTEAD AVE",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327133875",
            "telephone_number": "386-668-1156",
            "fax_number": "386-668-1156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN J SUSAN LPTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-19",
        "last_updated": "2009-03-17",
        "status": "A",
        "authorized_official_last_name": "SUSAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "386-668-1156",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPTA"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 15708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Debary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; 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.