Susan A Doucette, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1162582401 Issued in UT

Practice address

2310 N 400 E
Suite C
North Logan, UT 84341

Phone

(435) 752-5200

Fax

(435) 752-5228

NPI assigned

Aug 30, 2006

Last updated

Mar 22, 2013By 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

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Logan Physical Therapy PC

  • Physical Therapy Clinic/Center
  • Logan, UT
  • NPI 1881738904
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1972613099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6518",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843416518",
            "telephone_number": "435-752-5200",
            "fax_number": "435-752-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 N 400 E",
            "address_2": "SUITE C",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "84341",
            "telephone_number": "435-752-5200",
            "fax_number": "435-752-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUCETTE",
        "first_name": "SUSAN",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "1162582401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Curtis R. Canning, MD, PC
• Dana Jackson, LCSW, LLC
• Carrie Day
• Jackson Walter Deere, MD
• Discover Wellness Center, LLC
• Melanie Douglass, RD
• Matthew Joseph Edrington
• Leila Elmi-Stuart, LCSW
• Kade Erickson, DPT
• Christopher Fabricius, ND

• Physical Therapist in North Logan, UT
• Providers in North Logan, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.