Active NPI
Carolyn A Cruz, OTR
- Occupational Therapist
- Westland, MI
National Provider Identifier
1104017672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201003054
- Practice address
- 30901 Palmer Rd
Westland, MI 48186-9529 - Phone
- (734) 367-8438
- Fax
- (734) 722-9524
- NPI assigned
- Aug 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201003054 | MI | Primary |
Addresses
Primary practice location
30901 Palmer Rd
Westland, MI 48186-9529
Mailing address
30901 Palmer Rd
Westland, MI 48186-9529
Phone (734) 367-8438
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508883299 | Other | MI | WRPH |
| 5201003054 | Other | MI | MI LICENSE |
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": "1186531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239580800000",
"number": "1104017672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30901 PALMER RD",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481869529",
"telephone_number": "734-367-8438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30901 PALMER RD",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481869529",
"telephone_number": "734-367-8438",
"fax_number": "734-722-9524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "CAROLYN",
"middle_name": "A",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-08",
"last_updated": "2009-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201003054",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WRPH",
"identifier": "1508883299",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MI LICENSE",
"identifier": "5201003054",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.