Individual provider Active NPI

Jamie M Stockdale, OTR/L

  • Occupational Therapist
  • West Bloomfield, MI
National Provider Identifier
1043951239
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201012877 Issued in MI
Practice address
6625 Daly Rd
West Bloomfield, MI 48322-3410
Phone
(248) 737-3430
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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 5201012877 MI Primary

Addresses

Primary practice location

6625 Daly Rd
West Bloomfield, MI 48322-3410

Mailing address

6625 Daly Rd
West Bloomfield, MI 48322-3410
Phone (248) 737-3430

Other practice location 1

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 325-2146

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jstockdale780855@direct.hfhs.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221008000187 MI Practitioner - Occupational Therapist in Private Practice 0547646911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201012877MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaufman Children'S Center PastSince Aug 28, 2022 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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1043951239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 DALY RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223410",
            "telephone_number": "248-737-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 DALY RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223410",
            "telephone_number": "248-737-3430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6777 W Maple Rd",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483223013",
            "country_code": "US",
            "telephone_number": "248-325-2146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOCKDALE",
        "first_name": "JAMIE",
        "middle_name": "M",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201012877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jstockdale780855@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "6777 W Maple Rd",
            "city": "West Bloomfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483223013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.