Active NPI
Sue Ellen Wilson, OTR/L
- Occupational Therapist
- Annapolis, MD
National Provider Identifier
1164993986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 01740
- Practice address
- 2644 Riva Rd
Annapolis, MD 21401-7427 - Phone
- (410) 222-5000
- NPI assigned
- Dec 6, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 01740 | MD | Primary |
Addresses
Primary practice location
2644 Riva Rd
Annapolis, MD 21401-7427
Mailing address
2644 Riva Rd
Annapolis, MD 21401-7427
Phone (410) 222-5000
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661731200000",
"number": "1164993986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2644 RIVA RD",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214017427",
"telephone_number": "410-222-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2644 RIVA RD",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214017427",
"telephone_number": "410-222-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SUE",
"middle_name": "ELLEN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-06",
"last_updated": "2022-08-29",
"certification_date": "2022-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "01740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Annapolis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.