Active NPI
Sharon Lee Quaco, OT
- Occupational Therapist
- Granger, IN
National Provider Identifier
1386828457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31002026A
- Practice address
- 430 West Cleveland Road
Apt.B23
Granger, IN 46530 - Phone
- (574) 243-9640
- Fax
- (574) 243-9640
- NPI assigned
- Dec 24, 2007
- Last updated
- Dec 24, 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 | 31002026A | IN | Primary |
Addresses
Primary practice location
430 West Cleveland Road
Apt.B23
Granger, IN 46530
Mailing address
22242 Roosevelt Rd
South Bend, IN 46614-9261
Phone (574) 299-0403
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 |
|---|---|---|---|
| 31002026A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198454400000",
"number": "1386828457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22242 ROOSEVELT RD",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466149261",
"telephone_number": "574-299-0403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 WEST CLEVELAND ROAD",
"address_2": "APT.B23",
"city": "GRANGER",
"state": "IN",
"postal_code": "46530",
"telephone_number": "574-243-9640",
"fax_number": "574-243-9640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUACO",
"first_name": "SHARON",
"middle_name": "LEE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-24",
"last_updated": "2007-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31002026A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Granger, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 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.