Susan Diane Denette

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTR1313 Issued in AR

Practice address

905 N Redmond Rd
Jacksonville, AR 72076-3622

Phone

(501) 982-0528

Fax

(501) 533-6380

NPI assigned

May 7, 2007

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 AR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pathfinder, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Jacksonville, AR
  • NPI 1326004466
  Medicare reassignment NPD
• Pathfinder, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jacksonville, AR
  • NPI 1629035043
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253577600000",
    "number": "1467665521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 KATYE LN",
            "city": "SHERWOOD",
            "state": "AR",
            "postal_code": "721202733",
            "telephone_number": "501-834-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 N REDMOND RD",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720763622",
            "telephone_number": "501-982-0528",
            "fax_number": "501-533-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENETTE",
        "first_name": "SUSAN",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2009-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR1313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica E Davis, RN
• Jackalyn Leigh Davis, LPC
• Judy Davis, RN
• Juliana Brook Davis, TECHNICIAN
• Ronald F Davis, MEDICAL DIANOSTIC TE
• Marissa Dent, OTD, OTR/L
• Ordrey L Denton
• Jasmine Desai, PHARM.D.
• Peyton Nicole Diaz, M.A., CCC-SLP
• Amanda Katherine Diehl, LMSW

• Occupational Therapist in Jacksonville, AR
• Providers in Jacksonville, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; 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.