Individual provider Active NPI

Susan Janette McDowell, P.T.A.

  • Community Health Worker
  • Saint Louis, MO
National Provider Identifier
1831498955
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
117346 Issued in MO
Practice address
11960 Westline Industrial Dr
Saint Louis, MO 63146-3209
Phone
(314) 819-0480
NPI assigned
Mar 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 117346 MO Primary

Addresses

Primary practice location

11960 Westline Industrial Dr
Saint Louis, MO 63146-3209

Mailing address

208 S Woodward St
Easton, MO 64443
Phone (816) 344-4392

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

LicenseStateTypeSpecialty
117346MOMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1831498955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 S WOODWARD ST",
            "city": "EASTON",
            "state": "MO",
            "postal_code": "64443",
            "telephone_number": "816-344-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11960 WESTLINE INDUSTRIAL DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463209",
            "telephone_number": "314-819-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOWELL",
        "first_name": "SUSAN",
        "middle_name": "JANETTE",
        "name_prefix": "Mrs.",
        "credential": "P.T.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MO",
            "license": "117346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; 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.