Active NPI
Susan Marie Kube II, OTR
- Occupational Therapist
- Iron Mountain, MI
National Provider Identifier
1205916376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201002001
- Practice address
- 325 E H St
Iron Mountain, MI 49801-4760 - Phone
- (906) 774-3300
- Fax
- (906) 779-3187
- NPI assigned
- Oct 16, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201002001 | MI | Primary |
| Occupational Therapist | 225X00000X | 2740-026 | WI |
Addresses
Primary practice location
325 E H St
Iron Mountain, MI 49801-4760
Mailing address
W8979 Frei Dr
Iron Mountain, MI 49801-9449
Phone (906) 774-3300
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2740-026 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205916376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W8979 FREI DR",
"city": "IRON MOUNTAIN",
"state": "MI",
"postal_code": "498019449",
"telephone_number": "906-774-3300",
"fax_number": "906-779-3187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 E H ST",
"city": "IRON MOUNTAIN",
"state": "MI",
"postal_code": "498014760",
"telephone_number": "906-774-3300",
"fax_number": "906-779-3187"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUBE",
"first_name": "SUSAN",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"name_suffix": "II",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201002001",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "2740-026",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Iron Mountain, MI
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.