Susan Elizabeth Ebert, BS PHYSICAL THERAPY

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

01372 Issued in MO

Practice address

1360 Hialeah Place
Florissant, MO 63033-2215

Phone

(314) 921-8551

NPI assigned

Jun 27, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

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.

• Innovative Therapy Initiative

  • Physical Therapist
  • Saint Louis, MO
  • NPI 1851258743
  NPD

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498521600000",
    "number": "1932629243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 HIALEAH PL",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630332215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 HIALEAH PLACE",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630332215",
            "telephone_number": "314-921-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERT",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "BS PHYSICAL THERAPY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2017-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "01372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ear, Head & Neck Specialists
• Reuben Arvell Easter III, LMT
• Angela R Easterling
• Easy Care Consumer Directed Services LLC
• Jacqueline Eaton
• Chunichi Marmecia Echols
• Joseph C Eckert, DO
• Kelli Eckert, LCSW
• Justine Ann Eckhoff, MOT, OTR/L
• Larry Edger II, MSW

• Physical Therapist in Florissant, MO
• Providers in Florissant, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; 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.