Individual provider Active NPI

Michelle Sturdevant, OT

  • Occupational Therapist
  • Traverse City, MI
National Provider Identifier
1093137770
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201002869 Issued in MI
Practice address
2950 Lafranier Rd
Traverse City, MI 49686-4918
Phone
(231) 947-0506
NPI assigned
Jan 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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 5201002869 MI Primary

Addresses

Primary practice location

2950 Lafranier Rd
Traverse City, MI 49686-4918

Mailing address

2472 Leisure LN
Traverse City, MI 49686-4993
Phone (989) 745-4958

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

NPI Registry JSON

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

{
    "created_epoch": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1093137770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2472 LEISURE LN",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496864993",
            "telephone_number": "989-745-4958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 LAFRANIER RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496864918",
            "telephone_number": "231-947-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURDEVANT",
        "first_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-14",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201002869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; 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.