Individual provider Active NPI

Larna Gervasi Andrews, OTR/L

  • Neurorehabilitation Occupational Therapist
  • Detroit, MI
National Provider Identifier
1063905313
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X
License
5201001776 Issued in MI
Practice address
261 Mack Ave
Detroit, MI 48201-2417
Phone
(248) 305-7375
NPI assigned
Jun 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurorehabilitation Occupational Therapist 225XN1300X 5201001776 MI Primary

Addresses

Primary practice location

261 Mack Ave
Detroit, MI 48201-2417

Mailing address

261 Mack Ave
Detroit, MI 48201-2495
Phone (313) 745-1100

Other practice location 1

42005 W 12 Mile Rd
Novi, MI 48377-3113
Phone (248) 305-7375

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

LicenseStateTypeSpecialty
5201001776MIMDNeurorehabilitation Occupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1063905313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012495",
            "telephone_number": "313-745-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012417",
            "telephone_number": "248-305-7375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42005 W 12 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "483773113",
            "country_code": "US",
            "telephone_number": "248-305-7375",
            "fax_number": "248-305-7556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "LARNA",
        "middle_name": "GERVASI",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "MI",
            "license": "5201001776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.