Active NPI
Susan K Tedesco, OTR/L
- Occupational Therapist
- Colorado Springs, CO
National Provider Identifier
1447509401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0003500
- Practice address
- 3236 W Fontanero Street
Colorado Springs, CO 80904 - Phone
- (719) 598-1336
- NPI assigned
- Sep 6, 2012
- Last updated
- Sep 6, 2012
- 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 | 0003500 | CO | Primary |
Addresses
Primary practice location
3236 W Fontanero Street
Colorado Springs, CO 80904
Mailing address
7550 Assissi Heights
Colorado Springs, CO 80919
Phone (719) 598-1336
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 |
|---|---|---|---|
| 0003500 | CO | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346889600000",
"number": "1447509401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7550 ASSISSI HEIGHTS",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80919",
"telephone_number": "719-598-1336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3236 W FONTANERO STREET",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "80904",
"telephone_number": "719-598-1336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEDESCO",
"first_name": "SUSAN",
"middle_name": "K",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-06",
"last_updated": "2012-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CO",
"license": "0003500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.