Individual provider Active NPI

Maureen Elizabeth Palmer, OTR, CIMT

  • Occupational Therapist
  • Southfield, MI
National Provider Identifier
1013931955
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
MP000744 Issued in MI
Practice address
25811 W 12 Mile Rd
Suite 101
Southfield, MI 48034-1896
Phone
(248) 356-7415
Fax
(248) 356-7416
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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 MP000744 MI Primary

Addresses

Primary practice location

25811 W 12 Mile Rd
Suite 101
Southfield, MI 48034-1896

Mailing address

38062 Ross St
Livonia, MI 48154-4865
Phone (734) 462-8447

Other identifiers 1

IdentifierTypeStateIssuer
7506643OtherMIAETNA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
MP000744MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physio-Dynamics, LLC Past Accepting new patients
Michigan Therapeutic Solutions, Inc. Past Accepting new patients

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203465600000",
    "number": "1013931955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38062 ROSS ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481544865",
            "telephone_number": "734-462-8447",
            "fax_number": "734-542-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25811 W 12 MILE RD",
            "address_2": "SUITE 101",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341896",
            "telephone_number": "248-356-7415",
            "fax_number": "248-356-7416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "MAUREEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "OTR, CIMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "MP000744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7506643",
            "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 Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.