NPIMap

Organization Active NPI

Susquehanna Physician Services

  • Physical Therapist
  • Mansfield, PA
National Provider Identifier
1982205472
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SUSQUEHANNA PHYSICIAN SERVICES
Practice address
416 S Main St Ste 1
Mansfield, PA 16933-1510
Phone
(570) 662-1920
Fax
(570) 662-1921
NPI assigned
Nov 3, 2020
Last updated
Dec 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Authorized official

Name
Melissa Davis
Title
VP/Coo
Phone
(570) 326-8544

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

416 S Main St Ste 1
Mansfield, PA 16933-1510

Mailing address

1201 Grampian Blvd
Williamsport, PA 17701-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210810001811 PA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 2264336460 Practice locations: Mansfield, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982205472. Details of each certification follow.

  • CCN 396876 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 396876

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SUSQUEHANNA HEALTH MEDICAL PLAZA AT MANSFIELD
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Nov 1, 2017
Last certification
Oct 5, 2023
Ownership / control type
Voluntary Non-Profit Other Than Church
Facility address
416 South Main Street Suite 1
Mansfield, PA 16933

National Provider Directory

National Provider Directory
Tax ID family
SPS LH Family Practice26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

416 S Main St
Ste 1
Mansfield, PA 16933
Phone (570) 662-1920

NPI Registry JSON

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1982205472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 GRAMPIAN BLVD",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177011900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 S MAIN ST STE 1",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "169331510",
            "telephone_number": "570-662-1920",
            "fax_number": "570-662-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSQUEHANNA PHYSICIAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-03",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "VP/COO",
        "authorized_official_telephone_number": "570-326-8544"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, PA

Sources for this page

Verify at the official NPI Registry.