Individual provider Active NPI

Susan Jahn

  • Pediatric Occupational Therapist
  • Marietta, OH
National Provider Identifier
1134520356
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OH-006709 Issued in OH
Practice address
1338A Colegate Dr
Marietta, OH 45750
Phone
(740) 373-6669
Fax
(740) 376-5809
NPI assigned
Sep 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OH-006709 OH
Occupational Therapist 225X00000X 1288 WV
Pediatric Occupational Therapist 225XP0200X OH-006709 OH Primary

Addresses

Primary practice location

1338A Colegate Dr
Marietta, OH 45750

Mailing address

1338A Colegate Dr
Marietta, OH 45750
Phone (740) 373-6669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200506003111 OH Practitioner - Occupational Therapist in Private Practice 0749611739 Reassigns benefits to 1 organization
I20220630000653 WV Practitioner - Occupational Therapist in Private Practice 0749611739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, shared by 24 NPIs, 976 clinicians

Practice addresses (Care Compare)

110 Nicolette Rd
Parkersburg, WV 26104-7241
Phone (304) 424-6023

150 Browns Rd
Marietta, OH 45750-9085
Phone (740) 629-9791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OH-006709OHMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Mar 22, 2020 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince May 1, 2022 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Mar 22, 2020 Accepting new patients

Locations

150 Browns Rd
Marietta, OH 45750
Phone (740) 373-9600

110 Nicolette Rd
Parkersburg, WV 26104
Phone (304) 424-6023

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1134520356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1338A COLEGATE DR",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "45750",
            "telephone_number": "740-373-6669",
            "fax_number": "740-376-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338A COLEGATE DR",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "45750",
            "telephone_number": "740-373-6669",
            "fax_number": "740-376-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHN",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OH-006709",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "1288",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "OH",
            "license": "OH-006709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.