Active NPI
Susan Diane Stern, OTR
- Pediatric Occupational Therapist
- Elkridge, MD
National Provider Identifier
1063639953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 03889
- Practice address
- 7300 Golden Fern CT
Elkridge, MD 21075-5946 - Phone
- (410) 796-8499
- Fax
- (443) 270-8260
- NPI assigned
- Apr 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 03889 | MD | Primary |
Addresses
Primary practice location
7300 Golden Fern CT
Elkridge, MD 21075-5946
Mailing address
3103 Saint Florence Ter
Olney, MD 20832-1619
Phone (301) 570-0348
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 |
|---|---|---|---|
| 03889 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063639953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3103 SAINT FLORENCE TER",
"city": "OLNEY",
"state": "MD",
"postal_code": "208321619",
"telephone_number": "301-570-0348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7300 GOLDEN FERN CT",
"city": "ELKRIDGE",
"state": "MD",
"postal_code": "210755946",
"telephone_number": "410-796-8499",
"fax_number": "443-270-8260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STERN",
"first_name": "SUSAN",
"middle_name": "DIANE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "MD",
"license": "03889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkridge, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.