Active NPI
Ellen Disler, COTA
- Occupational Therapy Assistant
- Farmington Hills, MI
National Provider Identifier
1104125814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 32001539A
- Practice address
- 27240 Haggerty Rd # 15
Farmington Hills, MI 48331-5716 - Phone
- (248) 488-0350
- NPI assigned
- Mar 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 Therapy Assistant | 224Z00000X | 32001539A | IN | Primary |
Addresses
Primary practice location
27240 Haggerty Rd # 15
Farmington Hills, MI 48331-5716
Mailing address
1586 Preidt Cir
Franklin, IN 46131-7589
Phone (248) 488-0350
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
| License | State | Type | Specialty |
|---|---|---|---|
| 32001539A | IN | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300665600000",
"number": "1104125814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1586 PREIDT CIR",
"city": "FRANKLIN",
"state": "IN",
"postal_code": "461317589",
"telephone_number": "248-488-0350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27240 HAGGERTY RD # 15",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483315716",
"telephone_number": "248-488-0350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DISLER",
"first_name": "ELLEN",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-21",
"last_updated": "2011-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "IN",
"license": "32001539A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.