Individual provider Active NPI

Susan Lorraine Reid, LMT

  • Mechanotherapist
  • Seminole, FL
National Provider Identifier
1841426616
Registry record updated Jun 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
MA6609 Issued in FL
Practice address
8209 113TH St
Seminole, FL 33772-4128
Phone
(727) 543-2144
NPI assigned
Jun 5, 2009
Last updated
Jun 5, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X MA6609 FL Primary

Addresses

Primary practice location

8209 113TH St
Seminole, FL 33772-4128

Mailing address

1028 Commodore St
Apt 4
Clearwater, FL 33755-1014
Phone (727) 543-2144

Other identifiers 1

IdentifierTypeStateIssuer
C1838OtherFLBLUE CROSS BLUE SHEILD

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
MA6609FLMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1244160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244160000000",
    "number": "1841426616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 COMMODORE ST",
            "address_2": "APT 4",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337551014",
            "telephone_number": "727-543-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8209 113TH ST",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337724128",
            "telephone_number": "727-543-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "SUSAN",
        "middle_name": "LORRAINE",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "FL",
            "license": "MA6609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "C1838",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.