Individual provider Active NPI

Traci Hammis, OTR

  • Occupational Therapist
  • Saginaw, MI
National Provider Identifier
1003183054
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201003901 Issued in MI
Practice address
5935 Shattuck Rd
Saginaw, MI 48603-2699
Phone
(989) 399-2001
Fax
(989) 790-5767
NPI assigned
Nov 18, 2011
Last updated
Nov 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201003901 MI Primary

Addresses

Primary practice location

5935 Shattuck Rd
Saginaw, MI 48603-2699

Mailing address

5935 Shattuck Rd
Saginaw, MI 48603-2699
Phone (989) 399-2001

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240814004012 MI Practitioner - Occupational Therapist in Private Practice 4789122235 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Aug 5, 2024 Accepting new patients
Peak Rehab LLC Occupational Therapist CurrentSince Jun 11, 2024 Accepting new patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Aug 5, 2024 Accepting new patients

Locations

5050 Amelia Earhart Dr
Linden, MI 48451
Phone (810) 735-3458

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (919) 861-2441

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1321574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1003183054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5935 SHATTUCK RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032699",
            "telephone_number": "989-399-2001",
            "fax_number": "989-790-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5935 SHATTUCK RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486032699",
            "telephone_number": "989-399-2001",
            "fax_number": "989-790-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMIS",
        "first_name": "TRACI",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-18",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201003901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.