Individual provider Active NPI

Lee Austin Wilford

  • Occupational Therapist
  • Rochester, MI
National Provider Identifier
1003405747
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201011111 Issued in MI
Practice address
500 E University Dr
Rochester, MI 48307-7206
Phone
(989) 750-8511
NPI assigned
Jan 17, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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 5201011111 MI Primary

Addresses

Primary practice location

500 E University Dr
Rochester, MI 48307-7206

Mailing address

2407 N Raymond Rd
Midland, MI 48642-7294
Phone (989) 750-8511

Other practice location 1

255 Mayer Rd
Frankenmuth, MI 48734-1358
Phone (989) 264-1989

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250829004130 MI Practitioner - Occupational Therapist in Private Practice 8022519065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

125 Emeryville Dr
Suite 320
Cranberry Township, PA 16066-5023

2009 Brookfield Dr
Midland, MI 48642-3264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Powerback Rehabilitation LLC Occupational Therapist CurrentSince Aug 1, 2025 Accepting new patients
Powerback Rehabilitation LLC Occupational Therapist CurrentSince Aug 1, 2025 Accepting new patients

Locations

2885 10 Mile Rd NE
Rockford, MI 49341
Phone (616) 326-0010

7005 Pontiac Trl
West Bloomfield, MI 48323
Phone (248) 681-2476

101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436

Organizations & group practices 2

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": "1610841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1003405747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2407 N RAYMOND RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486427294",
            "telephone_number": "989-750-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E UNIVERSITY DR",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483077206",
            "telephone_number": "989-750-8511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Mayer Rd",
            "address_purpose": "LOCATION",
            "city": "Frankenmuth",
            "state": "MI",
            "postal_code": "487341358",
            "country_code": "US",
            "telephone_number": "989-264-1989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILFORD",
        "first_name": "LEE",
        "middle_name": "AUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-17",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201011111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.