Active NPI
Susan Gann, OT/L
- Occupational Therapist
- Lewes, DE
National Provider Identifier
1649552076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- U1-0012526
- Practice address
- 17512 Shady Rd
Lewes, DE 19958-6236 - Phone
- (302) 444-8318
- Fax
- (302) 444-8309
- NPI assigned
- Sep 12, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 46TR00359400 | NY | |
| Occupational Therapist | 225X00000X | U1-0012526 | DE | Primary |
Addresses
Primary practice location
17512 Shady Rd
Lewes, DE 19958-6236
Mailing address
17512 Shady Rd
Lewes, DE 19958-6236
Phone (302) 444-8318
Other names 1
- Susan Kelly
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
37517 Golden Eagle Blvd
Lewes, DE 19958-7044
Phone (302) 444-8318
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| U1-0012526 | DE | MD | Occupational Therapist |
| 46TR00359400 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aging in Place Specialists | Current | 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 and National Provider Directory roles.
-
- Home Health Agency
- Lewes, DE
- NPI 1528427622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699574400000",
"number": "1649552076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17512 SHADY RD",
"city": "LEWES",
"state": "DE",
"postal_code": "199586236",
"telephone_number": "302-444-8318",
"fax_number": "302-444-8309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17512 SHADY RD",
"city": "LEWES",
"state": "DE",
"postal_code": "199586236",
"telephone_number": "302-444-8318",
"fax_number": "302-444-8309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANN",
"first_name": "SUSAN",
"credential": "OT/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-12",
"last_updated": "2023-11-10",
"certification_date": "2023-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "46TR00359400",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "DE",
"license": "U1-0012526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SUSAN",
"last_name": "KELLY",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Lewes, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.