Individual provider Active NPI

Susan Feller, OTR/L, PT

  • Specialist
  • Phoenix, AZ
National Provider Identifier
1619074663
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0181 Issued in AZ
Practice address
15002 N 32ND St
Phoenix, AZ 85032-4441
Phone
(602) 449-2035
NPI assigned
Sep 20, 2006
Last updated
May 12, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0181 AZ Primary
Specialist 174400000X 1080 AZ

Addresses

Primary practice location

15002 N 32ND St
Phoenix, AZ 85032-4441

Mailing address

15002 N 32ND St
Phoenix, AZ 85032-4441

Other identifiers 2

IdentifierTypeStateIssuer
786915MedicaidAZ
445694MedicaidAZ

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1080AZMDSports Physician Chiropractor
0181AZMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Paradise Valley Unified School District Past Accepting new patients
Hosmer Physical Therapy Corp. PastSince Jun 15, 2009 Accepting new patients

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1619074663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15002 N 32ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15002 N 32ND ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324441",
            "telephone_number": "602-449-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLER",
        "first_name": "SUSAN",
        "credential": "OTR/L, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "0181",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AZ",
            "license": "1080",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "786915",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "445694",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.