Active NPI
Susan Elizabeth Hicks, O.T.
- Occupational Therapist
- Hilo, HI
National Provider Identifier
1679763296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 30
- Practice address
- 1180 Waianuenue Ave
Hawaii State Veterans Hospital
Hilo, HI 96720 - Phone
- (808) 974-4500
- NPI assigned
- Jul 30, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT 30 | HI | Primary |
Addresses
Primary practice location
1180 Waianuenue Ave
Hawaii State Veterans Hospital
Hilo, HI 96720
Mailing address
HC 3 Box 13104
Keaau, HI 96749-9227
Phone (808) 966-7372
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
| License | State | Type | Specialty |
|---|---|---|---|
| OT 30 | HI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185753600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185753600000",
"number": "1679763296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 3 BOX 13104",
"city": "KEAAU",
"state": "HI",
"postal_code": "967499227",
"telephone_number": "808-966-7372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1180 WAIANUENUE AVE",
"address_2": "HAWAII STATE VETERANS HOSPITAL",
"city": "HILO",
"state": "HI",
"postal_code": "96720",
"telephone_number": "808-974-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "SUSAN",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "O.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-30",
"last_updated": "2007-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "HI",
"license": "OT 30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hilo, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.