Susan Louise Dykema

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201000873 Issued in MI

Practice address

418 S Weber St
Colorado Springs, CO 80903-2127

Phone

(719) 785-3742

NPI assigned

Jun 26, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1497275846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6385 CORPORATE DR STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809195901",
            "telephone_number": "719-354-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 S WEBER ST",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032127",
            "telephone_number": "719-785-3742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKEMA",
        "first_name": "SUSAN",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-26",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201000873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tucker Dye
• Jordan Alexandra Dyer, CRNA
• William Christopher Dyer, DDS
• John R Dygert, DO
• Macy Rose Dyke
• Trisha Dawn Dykema, LMT
• Keenan Dykes
• Lara CT Dykhuis, CCC-SLP
• Dynamic Family Medicine PLLC
• Dynamic Minds Institute, LLC (Dynamic Minds)

• Occupational Therapist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Occupational Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.