Individual provider Active NPI

Susan F Stern, OTR/L

  • Occupational Therapist
  • Lexington, KY
National Provider Identifier
1942565163
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
135463 Issued in KY
Practice address
841 Corporate Dr Ste 301
Lexington, KY 40503-5424
Phone
(859) 333-9312
Fax
(620) 508-2008
NPI assigned
Jul 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X KY
Pediatric Occupational Therapist 225XP0200X R3536 KY
Occupational Therapist 225X00000X 135463 KY Primary

Addresses

Primary practice location

841 Corporate Dr Ste 301
Lexington, KY 40503-5424

Mailing address

841 Corporate Dr
Ste 301
Lexington, KY 40503-5424
Phone (859) 224-2271

Other identifiers 1

IdentifierTypeStateIssuer
7100223850MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@myfascialhealth.com Fascial Health LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120823000737 KY Practitioner - Occupational Therapist in Private Practice 5193972354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fascial Health, LLCGroup PAC ID 9032540422, 2 clinicians

Practice addresses (Care Compare)

811 Corporate Dr
Suite 200
Lexington, KY 40503-5409
Phone (859) 333-9312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fascial Health LLC Occupational Therapist CurrentSince Sep 7, 2021 Accepting new patients
The Weston Group Inc. CurrentSince Jul 22, 2024 Accepting new patients
The Weston Group Inc Occupational Therapist CurrentSince Jul 22, 2024 Accepting new patients

Locations

811 Corporate Dr
Ste 200
Lexington, KY 40503
Phone (859) 279-1955

841 Corporate Dr
Ste 301
Lexington, KY 40503
Phone (859) 333-9312

150 Shoreside Dr
Lexington, KY 40515
Phone (859) 721-0350

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1942565163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 CORPORATE DR",
            "address_2": "STE 301",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405035424",
            "telephone_number": "859-224-2271",
            "fax_number": "859-224-4675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 CORPORATE DR STE 301",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405035424",
            "telephone_number": "859-333-9312",
            "fax_number": "620-508-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "SUSAN",
        "middle_name": "F",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "KY",
            "license": "R3536",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "135463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100223850",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@myfascialhealth.com",
            "affiliation": "Y",
            "endpointDescription": "business email",
            "affiliationName": "Fascial Health LLC",
            "address_1": "841 Corporate Dr Ste 301",
            "city": "Lexington",
            "state": "KY",
            "country_code": "US",
            "postal_code": "405035424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.