Individual provider Active NPI

Bridget Doyle Benoit

  • Occupational Therapist
  • Niles, MI
National Provider Identifier
1104326503
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201010012 Issued in MI
Practice address
541 Union St
Niles, MI 49120-1536
Phone
(248) 425-4606
NPI assigned
Feb 13, 2018
Last updated
May 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT010017 OH
Occupational Therapist 225X00000X 5201010012 MI Primary

Addresses

Primary practice location

541 Union St
Niles, MI 49120-1536

Mailing address

541 Union St
Niles, MI 49120-1536
Phone (248) 425-4606

Other practice location 1

6528 Cornwall Ct
Sylvania, OH 43560-3103
Phone (248) 425-4606

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

State licenses

LicenseStateTypeSpecialty
5201010012MIMDOccupational Therapist
OT010017OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Indpendence at Home PLLC Occupational Therapist CurrentSince May 24, 2020 Accepting new patients
Dignitas Vitae Home Care LLC Current Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1104326503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 UNION ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491201536",
            "telephone_number": "248-425-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 UNION ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491201536",
            "telephone_number": "248-425-4606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6528 Cornwall Ct",
            "address_purpose": "LOCATION",
            "city": "Sylvania",
            "state": "OH",
            "postal_code": "435603103",
            "country_code": "US",
            "telephone_number": "248-425-4606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENOIT",
        "first_name": "BRIDGET",
        "middle_name": "DOYLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT010017",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201010012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.