Active NPI
Susan Netherland
- Occupational Therapist
- Kingsport, TN
National Provider Identifier
1386039006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4010
- Practice address
- 2000 Brookside Dr
Kingsport, TN 37660-4627 - Phone
- (423) 857-7000
- NPI assigned
- Mar 31, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 4010 | TN | Primary |
Addresses
Primary practice location
2000 Brookside Dr
Kingsport, TN 37660-4627
Mailing address
323 Nelson Ave
Piney Flats, TN 37686-4223
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 |
|---|---|---|---|
| 4010 | TN | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427760000000",
"number": "1386039006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "323 NELSON AVE",
"city": "PINEY FLATS",
"state": "TN",
"postal_code": "376864223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 BROOKSIDE DR",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376604627",
"telephone_number": "423-857-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NETHERLAND",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-31",
"last_updated": "2015-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "4010",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.