Active NPI
Susan Marie Gibson, OTR/L
- Occupational Therapist
- Hudson, OH
National Provider Identifier
1881082741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-2372
- Practice address
- 563 W Streetsboro St
Hudson, OH 44236-2050 - Phone
- (330) 650-0436
- NPI assigned
- Dec 30, 2014
- Last updated
- Dec 30, 2014
- 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 Therapist | 225X00000X | OT-2372 | OH | Primary |
Addresses
Primary practice location
563 W Streetsboro St
Hudson, OH 44236-2050
Mailing address
563 W Streetsboro St
Hudson, OH 44236-2050
Phone (330) 650-0436
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 |
|---|---|---|---|
| OT-2372 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419897600000",
"number": "1881082741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "563 W STREETSBORO ST",
"city": "HUDSON",
"state": "OH",
"postal_code": "442362050",
"telephone_number": "330-650-0436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "563 W STREETSBORO ST",
"city": "HUDSON",
"state": "OH",
"postal_code": "442362050",
"telephone_number": "330-650-0436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "SUSAN",
"middle_name": "MARIE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-30",
"last_updated": "2014-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OH",
"license": "OT-2372",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hudson, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.