Susie A Feshold, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

108185 Issued in TX

Practice address

1000 W Crosby Rd Ste 136
Carrollton, TX 75006-6904

Phone

(972) 237-0101

NPI assigned

Feb 25, 2018

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 identifiers 1

Other names 1

• Susie Haley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1519516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519516800000",
    "number": "1013418045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 W ARKANSAS LN",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760161909",
            "telephone_number": "682-867-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CROSBY RD STE 136",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066904",
            "telephone_number": "972-237-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FESHOLD",
        "first_name": "SUSIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-25",
        "last_updated": "2018-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "108185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225X00000X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSIE",
            "last_name": "HALEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.

Verify at the official NPI Registry.