Individual provider Active NPI

Susan Kaye Malicki, OTR

  • Occupational Therapist
  • Burlington, WI
National Provider Identifier
1639956360
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1082-26 Issued in WI
Practice address
709 Spring Valley Rd
Burlington, WI 53105-7614
Phone
(262) 971-9300
NPI assigned
Sep 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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 1082-26 WI Primary

Addresses

Primary practice location

709 Spring Valley Rd
Burlington, WI 53105-7614

Mailing address

709 Spring Valley Rd
Burlington, WI 53105-7614
Phone (262) 971-9300

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
1082-26WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1639956360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 SPRING VALLEY RD",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531057614",
            "telephone_number": "262-971-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 SPRING VALLEY RD",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531057614",
            "telephone_number": "262-971-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALICKI",
        "first_name": "SUSAN",
        "middle_name": "KAYE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "1082-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.