Annetta Hardamon, OT

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

5201000367 Issued in MI

Practice address

26776 W 12 Mile Rd Ste 101
Southfield, MI 48034-7807

Phone

(248) 450-3183

NPI assigned

Mar 3, 2021

Sex

Female

Sole proprietor

No

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

Specialty

Occupational Therapist in Private Practice

Education

Wayne State University School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ats Physical Therapy PLLCGroup PAC ID 8921436890, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ats Physical Therapy PLLC

  • Physical Therapist
  • Southfield, MI
  • NPI 1508417106
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1104411040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26776 W 12 MILE RD STE 101",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347807",
            "telephone_number": "248-450-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26776 W 12 MILE RD STE 101",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347807",
            "telephone_number": "248-450-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDAMON",
        "first_name": "ANNETTA",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "MI",
            "license": "5201000367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Happy Moms & Babies
• Donna Harber, MSW, CBT
• Dylan Hardenbrook
• Hamdan M Harhara, D.C.
• Antonio A Harlan
• Leigh Harless, CCC-A
• Harleys Hart Home Healthcare LLC

• Physical Rehabilitation Occupational Therapist in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Rehabilitation Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.