Susanne Peck, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201008659 Issued in MI

Practice address

2786 56TH St SW
Wyoming, MI 49418-8708

Phone

(616) 261-3960

NPI assigned

Dec 11, 2013

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

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Powerback Rehabilitation LLC

  • Physical Therapist
  • Shelby Township, MI
  • NPI 1912226366
  Medicare reassignment

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

{
    "created_epoch": "1386720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1447681895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 UNION ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033073",
            "telephone_number": "616-915-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2786 56TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "494188708",
            "telephone_number": "616-261-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "SUSANNE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-11",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201008659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Pasternak, DO
• Vrunda Patel, TLLP
• Pathways Residential Care LLC
• Jennifer Anne-Gluszewski Patterson, PT
• Stephen John Pawloski, RPH
• Pediatrics Primary Care PLLC
• Gabriel E Pedraza, MD
• Timothy J Pelkey, MD
• Elizabeth Pelletier
• Todd Anthony Penn, PHARM.D.

• Occupational Therapist in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.