Active NPI
Susan Carter Conklin, COTA L
- Occupational Therapy Assistant
- Moncks Corner, SC
National Provider Identifier
1851727481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 3240
- Practice address
- 104 Windwood LN
Cota L Not an Individual Business
Moncks Corner, SC 29461-9418 - Phone
- (843) 345-7027
- NPI assigned
- Sep 14, 2013
- 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 Therapy Assistant | 224Z00000X | 3240 | SC | Primary |
Addresses
Primary practice location
104 Windwood LN
Cota L Not an Individual Business
Moncks Corner, SC 29461-9418
Mailing address
104 Windwood LN
Moncks Corner, SC 29461-9418
Phone (843) 345-7027
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 |
|---|---|---|---|
| 3240 | SC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379116800000",
"number": "1851727481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 WINDWOOD LN",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294619418",
"telephone_number": "843-345-7027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 WINDWOOD LN",
"address_2": "COTA L NOT AN INDIVIDUAL BUSINESS",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294619418",
"telephone_number": "843-345-7027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONKLIN",
"first_name": "SUSAN",
"middle_name": "CARTER",
"name_prefix": "Mrs.",
"credential": "COTA L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-14",
"last_updated": "2013-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "SC",
"license": "3240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moncks Corner, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.