Individual provider Active NPI

Suzanne Gallagher, OTR/L

  • Occupational Therapist
  • Charlotte, NC
National Provider Identifier
1326590696
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8176 Issued in NC
Practice address
6030 Park South Dr
Charlotte, NC 28210-3241
Phone
(704) 909-2085
NPI assigned
Nov 2, 2016
Last updated
Jun 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 8176 NC Primary
Occupational Therapist 225X00000X OT24901 FL

Addresses

Primary practice location

6030 Park South Dr
Charlotte, NC 28210-3241

Mailing address

PO Box 124
Gallman, MS 39077-0124
Phone (866) 808-4133

Other practice location 1

2430 County Road 210 W Ste B
St Johns, FL 32259-2419
Phone (866) 808-4133

Other names 1

  • Suzanne Hayes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241113004578 FL Practitioner - Occupational Therapist in Private Practice 1951835974 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT24901FLMDOccupational Therapist
8176NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab in Motion, LLC Occupational Therapist CurrentSince Jun 23, 2024 Accepting new patients
RWW Senior Living Outpatient Rehab Services, LLC CurrentSince Oct 1, 2024 Accepting new patients
RWW Senior Living Outpatient Rehab Services, LLC CurrentSince Oct 1, 2024 Accepting new patients
Rehab in Motion, LLC Occupational Therapist CurrentSince Jun 16, 2024 Accepting new patients
Powerback Rehabilitation LLC Occupational Therapist Past Accepting new patients

Locations

805 N Whittington Pkwy
Northfield, KY 40222
Phone (502) 627-7000

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1326590696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 124",
            "city": "GALLMAN",
            "state": "MS",
            "postal_code": "390770124",
            "telephone_number": "866-808-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 PARK SOUTH DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103241",
            "telephone_number": "704-909-2085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2430 County Road 210 W Ste B",
            "address_purpose": "LOCATION",
            "city": "St Johns",
            "state": "FL",
            "postal_code": "322592419",
            "country_code": "US",
            "telephone_number": "866-808-4133",
            "fax_number": "866-849-2728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLAGHER",
        "first_name": "SUZANNE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-02",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "8176",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT24901",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "HAYES",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.