Active NPI
Susan C Wilkinson, OTR
- Occupational Therapist
- Crownsville, MD
National Provider Identifier
1336264571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 04717
- Practice address
- 1454 Fairfield Loop Rd
Crownsville, MD 21032-2006 - Phone
- (410) 923-6820
- NPI assigned
- Mar 20, 2007
- 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 | 04717 | MD | Primary |
Addresses
Primary practice location
1454 Fairfield Loop Rd
Crownsville, MD 21032-2006
Mailing address
121 Lee Dr
Annapolis, MD 21403-4043
Phone (410) 507-9622
Other practice location 1
Diane Dr.
Ft Ashby, WV 26719
Phone (304) 298-3602
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 |
|---|---|---|---|
| 04717 | MD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552348800000",
"number": "1336264571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 LEE DR",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214034043",
"telephone_number": "410-507-9622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1454 FAIRFIELD LOOP RD",
"city": "CROWNSVILLE",
"state": "MD",
"postal_code": "210322006",
"telephone_number": "410-923-6820"
}
],
"practiceLocations": [
{
"address_1": "Diane Dr.",
"address_purpose": "LOCATION",
"city": "Ft Ashby",
"state": "WV",
"postal_code": "26719",
"country_code": "US",
"telephone_number": "304-298-3602",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILKINSON",
"first_name": "SUSAN",
"middle_name": "C",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2019-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "04717",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crownsville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.