SUSAN KIRK (NPI# 1124503651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124503651 |
| Entity Type | Individual |
| Full Name | SUSAN KIRK |
| Practice Address |
4935 Hillegas Rd Ste 200 Fort Wayne IN 46818-1934 |
| Practice Telephone | 2603381241 |
| Mailing Telephone | 2603381241 |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2018-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588707590 | Susan E. Kirk | Internal Medicine | Uva Endocrinology, 415 Ray C. Hunt Drive, Charlottesville, VA 22903 | 2007-02-15 |
| 1154575561 | Susan Edwinna Kirk | Physician Assistant | 6701 Fannin St, Bcm 320, Houston, TX 77030-2608 | 2008-11-12 |
| 1902960248 | Susan J Kirk | Speech-Language Pathologist | Sunnyside Unified School District No 12, 2238 E Ginter Road, Tucson, AZ 95706 | 2006-12-21 |
| 1285737114 | Susan Kirk | Social Worker | 10130 Perimeter Pkwy, Ste 200, Charlotte, NC 28216-2447 | 2006-09-06 |
| Street Address |
4935 HILLEGAS RD STE 200 |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46818-1934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881734697 | Possibilities Northeast, LLC. | Psychologist | 4935 Hillegas Rd Ste 200, Fort Wayne, IN 46818-1934 | 2007-02-08 |
| 1629692405 | Nicole Kuhn | Physical Therapist | 4935 Hillegas Rd Ste 200, Fort Wayne, IN 46818-1943 | 2020-06-08 |
| 1659995769 | Lauren Ashley Hampton | Developmental Therapist | 4935 Hillegas Rd Ste 200, Fort Wayne, IN 46818-1943 | 2020-06-04 |
| 1720638406 | Ashley Noelle Yoder | Speech-Language Pathologist | 4935 Hillegas Rd Ste 200, Fort Wayne, IN 46818-1943 | 2019-09-16 |
| 1477103463 | Emalee Ann Reichenbach | Physical Therapist | 4935 Hillegas Rd Ste 200, Fort Wayne, IN 46818-1943 | 2019-09-12 |
| 1801445424 | Anna Marrah | Developmental Therapist | 4935 Hillegas Rd Ste 200, Fort Wayne, IN 46818-1943 | 2019-09-06 |
| 1649826991 | Allison Goepfrich | Developmental Therapist | 4935 Hillegas Rd Ste 200, Fort Wayne, IN 46818-1943 | 2019-08-13 |
| 1982265385 | Brittany Ormiston | Occupational Therapist | 4935 Hillegas Rd Ste 200, Fort Wayne, IN 46818-1943 | 2019-06-26 |
| 1639735731 | Marie Metzler | Developmental Therapist | 4935 Hillegas Rd Ste 200, Fort Wayne, IN 46818-1943 | 2019-05-14 |
| 1205391117 | Mallory Shupe | Speech-Language Pathologist | 4935 Hillegas Rd Ste 200, Fort Wayne, IN 46818-1943 | 2019-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710464938 | Heather Smith | Day Training/Habilitation Specialist | 9434 Lima Road, Suite C, Fort Wayne, IN 46818 | 2018-07-20 |
| 1184146748 | Danielle Macias | Speech-Language Pathologist | 4935 Hillegas Road, Suite 200, Fort Wayne, IN 46818 | 2017-07-14 |
| 1801326533 | Kimberly M Kindt | Optometrist | 9426 Lima Rd Ste C, Fort Wayne, IN 46818 | 2017-06-15 |
| 1578983359 | Sarah Buzzard | Occupational Therapy Assistant | 9426 Lima Road, A, Fort Wayne, IN 46818 | 2014-04-21 |
| 1306196704 | Peter Yang Gaw Go | Occupational Therapist | 3406 Bluefield Place, Fort Wayne, IN 46818 | 2012-09-12 |
| 1043593536 | Carol Lynn Steinbach | Massage Therapist | 12101 Hand Rd., Fort Wayne, IN 46818 | 2011-09-21 |
| 1295058071 | Summit Nutrition Services, LLC | Dietitian, Registered | 3027 Mariposa Place, Fort Wayne, IN 46818 | 2010-03-08 |
| 1184871899 | The Arc of Northeast Indiana, Inc | Intermediate Care Facility, Mentally Retarded | 9104 Strathmore Lane, Fort Wayne, IN 46818 | 2008-08-25 |
| 1285851121 | Angela Coleman | Dentist | 10505 Lima Road, Fort Wayne, IN 46818 | 2007-04-20 |
| 1942335534 | Angela S King | Dentist | 9019 Lima Road, Fort Wayne, IN 46818 | 2007-02-22 |
| Find all providers in zip 46818 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1306480603 | Linda Niedermeyer Okleshen | Developmental Therapist | 8413 Hunters Knoll Run, Fort Wayne, IN 46825-6406 | 2019-10-30 |
| 1447804109 | Ann Elisabeth Slen | Developmental Therapist | 1913 Omee Ct, Fort Wayne, IN 46815-7961 | 2019-07-30 |
| 1497067961 | Kelly Dawn Burke | Developmental Therapist | 6721 Clovercrest Dr, Fort Wayne, IN 46815-5403 | 2010-07-12 |
| 1679714661 | Melissa Lynn Kiser | Developmental Therapist | 826 Ridgewood Dr, Apt 1, Fort Wayne, IN 46805-1343 | 2009-03-20 |
| 1912165473 | Lori Rachel Brown | Developmental Therapist | 1302 Valdosta Dr, Fort Wayne, IN 46825-3526 | 2008-05-30 |
| 1023131448 | Donna Driscoll | Developmental Therapist | 5216 Lawford Ln, Fort Wayne, IN 46815-5131 | 2007-04-09 |
| 1215058268 | Julia Rose Rusk | Developmental Therapist | 226 N Seminole Cir, Fort Wayne, IN 46807-2865 | 2007-04-03 |
| 1073129599 | Stephanie Foss | Developmental Therapist | 2626 Saint Joe Center Rd, Fort Wayne, IN 46825-5042 | 2020-09-21 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46818 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.