Susan Collier

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2012030936 Issued in MO

Practice address

8228 Brentwood Industrial Dr
Brentwood, MO 63144-2815

Phone

(314) 781-0679

Fax

(314) 781-3448

NPI assigned

Jun 25, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Susan Goldak Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Prorehab, PC

  • Physical Therapy Clinic/Center
  • Edwardsville, IL
  • NPI 1851476378
  NPD (past)

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403654400000",
    "number": "1861807158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13537 BARRETT PARKWAY DR",
            "address_2": "SUITE 105",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630215899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8228 BRENTWOOD INDUSTRIAL DR",
            "city": "BRENTWOOD",
            "state": "MO",
            "postal_code": "631442815",
            "telephone_number": "314-781-0679",
            "fax_number": "314-781-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIER",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2014-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2012030936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "GOLDAK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Clarkson Optometry Inc
• Clay Scoliosis Clinic LLC
• Rachel Lynn Clay, DPT
• Erynn Elizabeth Coit, MOT, OTR/L
• Ashleigh Arielle Cole
• Kenneth Patrick Costello
• Madison Crowell
• Sabin Dang, MD
• Katie Davis
• Katie Marlene Davis, PHARMD

• Occupational Therapy Assistant in Brentwood, MO
• Providers in Brentwood, MO by specialty
• Occupational Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; 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.