Active NPI
Susan Ann Kinney, P.T.
- Physical Therapist
- West Roxbury, MA
National Provider Identifier
1811142698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9537
- Practice address
- 68 Lyall St
West Roxbury, MA 02132-1743 - Phone
- (617) 327-8223
- NPI assigned
- Nov 20, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 9537 | MA | Primary |
Addresses
Primary practice location
68 Lyall St
West Roxbury, MA 02132-1743
Mailing address
68 Lyall St
West Roxbury, MA 02132-1743
Phone (617) 327-8223
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 |
|---|---|---|---|
| 9537 | MA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carl Gustafson LLC | Physical Therapist | Past | Accepting new patients |
| Performance Rehabilitation of Western New England LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- Wellesley, MA
- NPI 1356366082
-
- Physical Therapist
- West Springfield, MA
- NPI 1710919063
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227139200000",
"number": "1811142698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 LYALL ST",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "021321743",
"telephone_number": "617-327-8223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 LYALL ST",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "021321743",
"telephone_number": "617-327-8223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINNEY",
"first_name": "SUSAN",
"middle_name": "ANN",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-20",
"last_updated": "2008-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MA",
"license": "9537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Roxbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.