Individual provider Active NPI

Sueji Goak

  • Occupational Therapist
  • Suwanee, GA
National Provider Identifier
1720580897
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT006493 Issued in GA
Practice address
3000 Celebration Blvd
Suwanee, GA 30024-1054
Phone
(480) 468-4050
NPI assigned
Mar 5, 2018
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 OT006493 GA Primary

Addresses

Primary practice location

3000 Celebration Blvd
Suwanee, GA 30024-1054

Mailing address

2222 Sullivan TRL
Easton, PA 18040-7958

Other practice location 1

4315 Johns Creek Pkwy
Suwanee, GA 30024-6048
Phone (480) 468-4050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180504001805 GA Practitioner - Occupational Therapist in Private Practice 2769746486 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of Pittsburgh School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Empowerme Rehabilitation Georgia, LLCGroup PAC ID 4284063835, 80 clinicians

Practice addresses (Care Compare)

4355 S Lee St
Buford, GA 30518-5756
Phone (678) 833-5567

4450 Old Hamilton Mill Rd
Buford, GA 30518-8813
Phone (678) 648-9892

5610 Hampton Park Dr
Cumming, GA 30041-4004
Phone (470) 866-5540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Oct 1, 2025 Accepting new patients
Legacy Healthcare Services, Inc. Occupational Therapist CurrentSince Oct 1, 2025 Accepting new patients
Legacy Healthcare Services, Inc. Occupational Therapist CurrentSince Oct 1, 2025 Accepting new patients
Empowerme Rehabilitation Georgia, LLC Occupational Therapist CurrentSince Mar 24, 2025 Accepting new patients

Locations

3333 E Cherokee Dr
Canton, GA 30115
Phone (470) 714-6698

5610 Hampton Park Dr
Cumming, GA 30041
Phone (470) 866-5540

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 287-3917

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1720580897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 SULLIVAN TRL",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180407958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 CELEBRATION BLVD",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241054",
            "telephone_number": "480-468-4050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4315 Johns Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300246048",
            "country_code": "US",
            "telephone_number": "480-468-4050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOAK",
        "first_name": "SUEJI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT006493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.