Individual provider Active NPI

Chelsea Gomori

  • Occupational Therapist
  • Lompoc, CA
National Provider Identifier
1134626609
Registry record updated Apr 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201009440 Issued in MI
Practice address
803 E Walnut Ave
Lompoc, CA 93436-7027
Phone
(805) 735-3714
NPI assigned
Apr 10, 2018
Last updated
Apr 10, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2018

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 16794 CA
Occupational Therapist 225X00000X 5201009440 MI Primary

Addresses

Primary practice location

803 E Walnut Ave
Lompoc, CA 93436-7027

Mailing address

15506 Dupage Blvd
Taylor, MI 48180-6021
Phone (313) 702-8195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181219002864 MI Practitioner - Occupational Therapist in Private Practice 2860737863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

42869 Woodward Ave
Bloomfield Hills, MI 48304-5036
Phone (248) 724-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Hand & Rehabilitation, LLC Occupational Therapist CurrentSince Dec 10, 2018 Accepting new patients
Comprehensive Hand & Rehabilitation, LLC CurrentSince Dec 10, 2018 Accepting new patients
Carnahan Therapy/the Work Center, Inc. Occupational Therapist Past Accepting new patients

Locations

42869 Woodward Ave
Bloomfield Hills, MI 48304
Phone (248) 724-4400

5798 Highland Rd
Waterford, MI 48327
Phone (248) 724-4400

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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1134626609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15506 DUPAGE BLVD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806021",
            "telephone_number": "313-702-8195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 E WALNUT AVE",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934367027",
            "telephone_number": "805-735-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMORI",
        "first_name": "CHELSEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "16794",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lompoc, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; 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.