Active NPI
Meredith Nackley, MOT, OTR/L
- Pediatric Occupational Therapist
- Southfield, MI
National Provider Identifier
1003296898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 5201009134
- Practice address
- 26440 Berg Rd
Unit 1006
Southfield, MI 48033-5394 - Phone
- (315) 534-9747
- NPI assigned
- Jun 5, 2015
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 5201009134 | MI | Primary |
Addresses
Primary practice location
26440 Berg Rd
Unit 1006
Southfield, MI 48033-5394
Mailing address
26440 Berg Rd
Unit 1006
Southfield, MI 48033-5394
Phone (315) 534-9747
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5201009134 | Other | MI | STATE OF MICHIGAN |
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 |
|---|---|---|---|
| 5201009134 | MI | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433462400000",
"number": "1003296898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26440 BERG RD",
"address_2": "UNIT 1006",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480335394",
"telephone_number": "315-534-9747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26440 BERG RD",
"address_2": "UNIT 1006",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480335394",
"telephone_number": "315-534-9747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NACKLEY",
"first_name": "MEREDITH",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-05",
"last_updated": "2015-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "MI",
"license": "5201009134",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MICHIGAN",
"identifier": "5201009134",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.