Individual provider Active NPI

Susanne Rose

  • Occupational Therapy Assistant
  • Abingdon, VA
National Provider Identifier
1669923769
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
0131000827 Issued in VA
Practice address
227 Campbell St SW
Abingdon, VA 24210-2403
Phone
(276) 701-7874
NPI assigned
Oct 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0131000827 VA Primary
Occupational Therapy Assistant 224Z00000X OTA0000001277 TN
Occupational Therapy Assistant 224Z00000X OTA12225 FL

Addresses

Primary practice location

227 Campbell St SW
Abingdon, VA 24210-2403

Mailing address

227 Campbell St SW
Abingdon, VA 24210-2403
Phone (276) 701-7874

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
OTA12225FLMDOccupational Therapy Assistant
OTA0000001277TNMDOccupational Therapy Assistant
0131000827VAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1669923769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 CAMPBELL ST SW",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102403",
            "telephone_number": "276-701-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 CAMPBELL ST SW",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242102403",
            "telephone_number": "276-701-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "SUSANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131000827",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "OTA0000001277",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA12225",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.