Individual provider Active NPI

Susan Jean Eckert, OTR

  • Occupational Therapist
  • Oldsmar, FL
National Provider Identifier
1497883292
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 11926 Issued in FL
Practice address
3865 Tampa Rd
Oldsmar, FL 34677-3008
Phone
(813) 394-5902
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT 11926 FL Primary

Addresses

Primary practice location

3865 Tampa Rd
Oldsmar, FL 34677-3008

Mailing address

22 Emerald Bay Dr
Oldsmar, FL 34677-5000
Phone (813) 394-5902

Other identifiers 1

IdentifierTypeStateIssuer
8917159 00MedicaidFL

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

LicenseStateTypeSpecialty
OT 11926FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1497883292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 EMERALD BAY DR",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346775000",
            "telephone_number": "813-394-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3865 TAMPA RD",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346773008",
            "telephone_number": "813-394-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKERT",
        "first_name": "SUSAN",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 11926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8917159 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oldsmar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.

Verify at the official NPI Registry.