Active NPI
Susan K Shumaker, PTA
- Physical Therapy Assistant
- Scranton, PA
National Provider Identifier
1972019347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- TE00633L
- Practice address
- 3 W Olive St Ste 118
Scranton, PA 18508-2576 - Phone
- (570) 961-3823
- Fax
- (570) 207-5988
- NPI assigned
- Dec 21, 2017
- Sex
- Female
- Sole proprietor
- No
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 Therapy Assistant | 225200000X | TE00633L | PA | Primary |
Addresses
Primary practice location
3 W Olive St Ste 118
Scranton, PA 18508-2576
Mailing address
3 W Olive St Ste 118
Scranton, PA 18508-2576
Phone (570) 961-3823
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TE000633L | Other | PA | LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| TE00633L | PA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1972019347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 W OLIVE ST STE 118",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185082576",
"telephone_number": "570-961-3823",
"fax_number": "570-207-5988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 W OLIVE ST STE 118",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185082576",
"telephone_number": "570-961-3823",
"fax_number": "570-207-5988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUMAKER",
"first_name": "SUSAN",
"middle_name": "K",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-21",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PA",
"license": "TE00633L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "TE000633L",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.