Theresa Anne McConnon, MS OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201009042 Issued in MI

Practice address

1215 E Michigan Ave
Lansing, MI 48912-1811

Phone

(517) 364-1000

NPI assigned

Feb 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1073014783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 PINCH HWY",
            "city": "POTTERVILLE",
            "state": "MI",
            "postal_code": "488768753",
            "telephone_number": "517-763-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-364-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNON",
        "first_name": "THERESA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MS OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073588711",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie M McClure, NP
• Matthew Stewart McClure, DO
• Naomi McClurg, LMSW
• David W McComb
• Rachel McConaughy
• Annie McCord
• Matthew McCord, M.D.
• Ryan McCormack, MD
• Devon McCoy
• Harry James McCoy, M.D.

• Occupational Therapist in Lansing, MI
• Providers in Lansing, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.