Individual provider Active NPI

Sarah Renee Surprenant, OTR/L

  • Occupational Therapist
  • Marion, IL
National Provider Identifier
1689859944
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.007020 Issued in IL
Practice address
3905 W Ernestine Dr
Suite B
Marion, IL 62959-5800
Phone
(618) 993-6237
Fax
(618) 997-3529
NPI assigned
Jan 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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 056.007020 IL Primary

Addresses

Primary practice location

3905 W Ernestine Dr
Suite B
Marion, IL 62959-5800

Mailing address

3905 W Ernestine Dr
Suite B
Marion, IL 62959-5800
Phone (618) 993-6237

Other identifiers 2

IdentifierTypeStateIssuer
213486OtherILGROUP
DG7011OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081126000417 IL Practitioner - Occupational Therapist in Private Practice 7810057437 Reassigns benefits to 1 organization
I20230411000266 TN Practitioner - Occupational Therapist in Private Practice 7810057437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation LLCGroup PAC ID 2769723162, 423 clinicians

Practice addresses (Care Compare)

1020 Charlie Daniels Pkwy
Mount Juliet, TN 37122-3064
Phone (877) 367-9772

1030 S Maple Ave
Cookeville, TN 38501-4061
Phone (931) 271-9490

1176 Warfield Blvd
Clarksville, TN 37043-6005
Phone (877) 367-9772

1250 Cedar Hills Dr
Cookeville, TN 38506-4347
Phone (931) 223-4862

1310 Rosewood Dr
Columbia, TN 38401-6434
Phone (931) 342-1712

2035 Vantage Pointe
Ashland City, TN 37015-4093
Phone (615) 380-4752

300 Celebration Cir
Franklin, TN 37067-1401
Phone (615) 274-9107

6961 Hwy 70 S
Nashville, TN 37221-2204
Phone (844) 502-7996

7015 Moores LN
Brentwood, TN 37027-2902
Phone (615) 412-8804

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056.007020ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation, LLC Occupational Therapist CurrentSince Mar 2, 2023 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince Sep 15, 2021 Accepting new patients
Empowerme Rehabilitation Illinois, LLC Occupational Therapist CurrentSince Sep 15, 2021 Accepting new patients
Empowerme Rehabilitation, LLC Occupational Therapist CurrentSince Mar 2, 2023 Accepting new patients
Ultimate Therapeutic Solutions, LLC PastSince Jan 5, 2016 Accepting new patients
Align Healthcares LLC Past Accepting new patients
Occupational Performance and Rehab, PC Occupational Therapist PastSince Feb 4, 2013 Accepting new patients
Performance Chiropractic of Southern Illinois LLC Past Accepting new patients
Align Healthcare LLC Past Accepting new patients

Locations

7108 Marine Rd
Edwardsville, IL 62025
Phone (618) 706-9759

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

1020 Charlie Daniels Pkwy
Mt Juliet, TN 37122
Phone (615) 758-4800

Organizations & group practices 9

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": "1199664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1689859944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 W ERNESTINE DR",
            "address_2": "SUITE B",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595800",
            "telephone_number": "618-993-6237",
            "fax_number": "618-997-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 W ERNESTINE DR",
            "address_2": "SUITE B",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595800",
            "telephone_number": "618-993-6237",
            "fax_number": "618-997-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURPRENANT",
        "first_name": "SARAH",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-07",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.007020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP",
            "identifier": "213486",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG7011",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; 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.