Individual provider Active NPI

Kelly Sauder, COTA/L

  • Occupational Therapy Assistant
  • Murrells Inlet, SC
National Provider Identifier
1942018031
Registry record updated Dec 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
4859 Issued in SC
Practice address
9405 Highway 17 Byp
Murrells Inlet, SC 29576-9301
Phone
(843) 650-2213
NPI assigned
Dec 21, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 4859 SC Primary

Addresses

Primary practice location

9405 Highway 17 Byp
Murrells Inlet, SC 29576-9301

Mailing address

9405 Highway 17 Byp
Murrells Inlet, SC 29576-9301
Phone (843) 650-2213

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
4859SCMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1734739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734739200000",
    "number": "1942018031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9405 HIGHWAY 17 BYP",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295769301",
            "telephone_number": "843-650-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9405 HIGHWAY 17 BYP",
            "city": "MURRELLS INLET",
            "state": "SC",
            "postal_code": "295769301",
            "telephone_number": "843-650-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAUDER",
        "first_name": "KELLY",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-21",
        "last_updated": "2024-12-21",
        "certification_date": "2024-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "4859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrells Inlet, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2024; 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.