Active NPI
Susan Hans, OTRL
- Pediatric Occupational Therapist
- Custer, SD
National Provider Identifier
1619039369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 0750
- Practice address
- 24941 America Center Rd
Custer, SD 57730-8335 - Phone
- (701) 367-4736
- NPI assigned
- Dec 15, 2006
- Last updated
- Mar 6, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 0750 | SD | Primary |
Addresses
Primary practice location
24941 America Center Rd
Custer, SD 57730-8335
Mailing address
24941 America Center Rd
Custer, SD 57730-8335
Phone (701) 367-4736
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B17351047567 | Other | ND | PREFERREDONE PIN NUMBER |
| 64-04763 | Other | ND | MEDICA PROVIDER NUMBER |
| HP75679 | Other | MN | HEALTHPARTNERS |
| LAN22704 | Other | ND | BCBS ND PROVIDER NUMBER |
| 2239246 | Other | ND | FIRST HEALTH |
| 385492000 | Other | MN | MHCP |
| 54430 | Medicaid | ND |
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 |
|---|---|---|---|
| 0750 | SD | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creative Kids Therapy | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425600000000",
"number": "1619039369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24941 AMERICA CENTER RD",
"city": "CUSTER",
"state": "SD",
"postal_code": "577308335",
"telephone_number": "701-367-4736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24941 AMERICA CENTER RD",
"city": "CUSTER",
"state": "SD",
"postal_code": "577308335",
"telephone_number": "701-367-4736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANS",
"first_name": "SUSAN",
"name_prefix": "Ms.",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-15",
"last_updated": "2015-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "SD",
"license": "0750",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERREDONE PIN NUMBER",
"identifier": "B17351047567",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA PROVIDER NUMBER",
"identifier": "64-04763",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP75679",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ND PROVIDER NUMBER",
"identifier": "LAN22704",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2239246",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHCP",
"identifier": "385492000",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "54430",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Custer, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.