Organization Active NPI

Susan Raychard LLC

  • Occupational Therapist
  • Kennebunk, ME
National Provider Identifier
1770069825
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
SUSAN RAYCHARD LLC
Practice address
20 Chamberlain Way
Kennebunk, ME 04043-7299
Phone
(207) 298-0071
NPI assigned
Jul 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Authorized official

Name
Susan Raychard, MOTNPI 1053851832
Title
Owner
Phone
(207) 298-0071

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

20 Chamberlain Way
Kennebunk, ME 04043-7299

Mailing address

PO Box 352
Kennebunk, ME 04043-0352
Phone (207) 298-0071

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181011001687 ME Part B Supplier - Clinic/Group Practice 5294086914 Receives reassigned benefits from 1 practitioner
Practice locations: Kennebunk, ME

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1770069825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 352",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040430352",
            "telephone_number": "207-298-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CHAMBERLAIN WAY",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040437299",
            "telephone_number": "207-298-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN RAYCHARD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "RAYCHARD",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-298-0071",
        "authorized_official_credential": "MOT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennebunk, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.