Individual provider Active NPI

Susan H. Kronenberger, OTR/L

  • Pediatric Occupational Therapist
  • Marietta, GA
National Provider Identifier
1821238627
Registry record updated Mar 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT000938 Issued in GU
Practice address
4939 Lower Roswell Rd
Building C, Suite 201
Marietta, GA 30068-4338
Phone
(770) 578-0860
Fax
(770) 578-1519
NPI assigned
Mar 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 6, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT000938 GA
Pediatric Occupational Therapist 225XP0200X OT000938 GU Primary

Addresses

Primary practice location

4939 Lower Roswell Rd
Building C, Suite 201
Marietta, GA 30068-4338

Mailing address

4939 Lower Roswell Rd
Building C, Suite 201
Marietta, GA 30068-4338
Phone (770) 578-0860

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
OT000938GAMDOccupational Therapist
OT000938GUMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236297600000",
    "number": "1821238627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4939 LOWER ROSWELL RD",
            "address_2": "BUILDING C, SUITE 201",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684338",
            "telephone_number": "770-578-0860",
            "fax_number": "770-578-1519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4939 LOWER ROSWELL RD",
            "address_2": "BUILDING C, SUITE 201",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684338",
            "telephone_number": "770-578-0860",
            "fax_number": "770-578-1519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRONENBERGER",
        "first_name": "SUSAN",
        "middle_name": "H.",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-06",
        "last_updated": "2009-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT000938",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GU",
            "license": "OT000938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.