Individual provider Active NPI

Susan Gann, OT/L

  • Occupational Therapist
  • Lewes, DE
National Provider Identifier
1649552076
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
U1-0012526 Issued in DE
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

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127002680 DE Practitioner - Occupational Therapist in Private Practice 5799958542 Reassigns benefits to 1 organization

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
Aging in Place SpecialistsGroup PAC ID 6709183627, 12 clinicians

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

LicenseStateTypeSpecialty
U1-0012526DEMDOccupational Therapist
46TR00359400NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aging in Place Specialists CurrentSince Nov 7, 2023 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.

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.

Verify at the official NPI Registry.