Donna Sue Costa

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.000851 Issued in IL

Practice address

550 W Frontage Rd Ste 2415
Northfield, IL 60093-1212

Phone

(877) 787-3422

NPI assigned

Sep 23, 2014

Last updated

Sep 23, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Donna Sue Glisson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Select Outpatient Services Inc

  • Rehabilitation Clinic/Center
  • Newcastle, WA
  • NPI 1285909531
  NPD (past)

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1932501715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W FRONTAGE RD STE 2415",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600931212",
            "telephone_number": "877-787-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W FRONTAGE RD STE 2415",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600931212",
            "telephone_number": "877-787-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTA",
        "first_name": "DONNA",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.000851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "GLISSON",
            "middle_name": "SUE",
            "credential": "LPTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen Cloyd, LCPC
• Emily Clysdale
• Alexandra Coello
• Suzanne Coleman, PT
• Collaborators, Inc.
• Jack Gerard Cox, MSW
• Lisa Crenshaw, B.S.W.
• Crescent Psychology, PLLC
• Maureen Flannery Crowe, LSW
• Carol Ann Cuellar

• Physical Therapy Assistant in Northfield, IL
• Providers in Northfield, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.

Verify at the official NPI Registry.