Lyndell Buckhannon Kerley, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201004097 Issued in MI

Practice address

34505 W 12 Mile Rd Ste 100
Farmington Hills, MI 48331-3287

Phone

(855) 559-7178

NPI assigned

Jan 21, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Therapy at Your Door LLC

  • Physical Therapist
  • Canton, MI
  • NPI 1255962197

  Occupational Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1104390426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 WEST DR",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492017719",
            "telephone_number": "517-740-7406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34505 W 12 MILE RD STE 100",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483313287",
            "telephone_number": "855-559-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKHANNON KERLEY",
        "first_name": "LYNDELL",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201004097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kailey Buck
• Marjorie Buck
• Matthew Buck
• Jocelyn Buckalew
• Kristina Marye Buckel
• Gloria Buckingham
• Kizzy Buckley-Williams
• Adeana Buckley
• Haely Buckley
• Jasmine Buckley

• Occupational Therapist in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.