Active NPI
Michelle Compton, COTA/L
- Occupational Therapy Assistant
- Bullhead City, AZ
National Provider Identifier
1033569413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 6266
- Practice address
- 2585 Miracle Mile Road
Unit #124
Bullhead City, AZ 86442 - Phone
- (928) 763-4030
- Fax
- (928) 854-5440
- NPI assigned
- Jun 16, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | |||
| Occupational Therapy Assistant | 224Z00000X | 6266 | AZ | Primary |
Addresses
Primary practice location
2585 Miracle Mile Road
Unit #124
Bullhead City, AZ 86442
Mailing address
1515 N. Lake Havasu Avenue
Suite #100
Lake Havasu City, AZ 86404
Phone (928) 854-5439
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6266 | Other | AZ | ARIZONA STATE BOARD OF OCCUPATIONAL THERAPY |
Other names 1
- Miss Michelle Ballard
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 |
|---|---|---|---|
| 6266 | AZ | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511740800000",
"number": "1033569413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 N. LAKE HAVASU AVENUE",
"address_2": "SUITE #100",
"city": "LAKE HAVASU CITY",
"state": "AZ",
"postal_code": "86404",
"telephone_number": "928-854-5439",
"fax_number": "928-854-5440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2585 MIRACLE MILE ROAD",
"address_2": "UNIT #124",
"city": "BULLHEAD CITY",
"state": "AZ",
"postal_code": "86442",
"telephone_number": "928-763-4030",
"fax_number": "928-854-5440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COMPTON",
"first_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-16",
"last_updated": "2017-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AZ",
"license": "6266",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARIZONA STATE BOARD OF OCCUPATIONAL THERAPY",
"identifier": "6266",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MICHELLE",
"last_name": "BALLARD",
"prefix": "MISS",
"credential": "COTA/L",
"code": "1",
"type": "Former Name"
}
]
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.