Susan Rebecca Mendenhall, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OC002549L Issued in PA

Practice address

1109 E Baltimore Pike
Kennett Square, PA 19348-2366

Phone

(610) 388-5013

Fax

(484) 259-0220

NPI assigned

Jun 18, 2024

Last updated

Jun 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1437992369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 E BALTIMORE PIKE",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193482366",
            "telephone_number": "610-388-5013",
            "fax_number": "484-259-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 E BALTIMORE PIKE",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193482366",
            "telephone_number": "610-388-5013",
            "fax_number": "484-259-0220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1660 E Street Rd",
            "address_purpose": "LOCATION",
            "city": "Kennett Square",
            "state": "PA",
            "postal_code": "193482300",
            "country_code": "US",
            "telephone_number": "610-388-5501",
            "fax_number": "484-259-0141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDENHALL",
        "first_name": "SUSAN",
        "middle_name": "REBECCA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC002549L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Kennett Square, PA
• Providers in Kennett Square, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.