Individual provider Active NPI

Jenieve Butler, OTR/L

  • Occupational Therapist
  • Oak Park, MI
National Provider Identifier
1093521890
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201014007 Issued in MI
Practice address
21700 Greenfield Rd Ste 257
Oak Park, MI 48237-2532
Phone
(248) 968-5600
NPI assigned
Dec 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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 5201014007 MI Primary

Addresses

Primary practice location

21700 Greenfield Rd Ste 257
Oak Park, MI 48237-2532

Mailing address

21700 Greenfield Rd Ste 257
Oak Park, MI 48237-2532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

30801 Jefferson Ave
Saint Clair Shores, MI 48082-1732

5926 Arban Dr
Troy, MI 48098-4673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201014007MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1733443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1093521890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21700 GREENFIELD RD STE 257",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21700 GREENFIELD RD STE 257",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372532",
            "telephone_number": "248-968-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JENIEVE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-06",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201014007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.