Alyssa Christine Davidson, OTR
Individual provider Active NPI Occupational Therapist · Grandville, MI
NPI 1154853984 · NPPES record last updated Jan 16, 2023
Key facts
- NPI
- 1154853984
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 5201009759 (MI)
- Practice address
- 3181 Prairie St SW Ste 115
Grandville, MI 49418-2097 - Phone
- (616) 260-3121
- NPI assigned
- Mar 30, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170410001184 | MI | Practitioner - Occupational Therapist in Private Practice | 5294011060 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5201009759 | MI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alyssa Davidson, LLC | Occupational Therapist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201009759 | MI | Yes |
Addresses
Primary practice location
3181 Prairie St SW Ste 115
Grandville, MI 49418-2097
Mailing address
3126 Harvest Ave SW
Grandville, MI 49418-1413
Phone (616) 260-3121
Other providers in Grandville, MI
- Samuel Dame
- Jonathan James Dargo
- Danielle Jennifer Darling
- Morgan Daul
- Dave'S Vision Center Inc.
- Amanda Davis
- Kristen Deam
- Matthew Dearlove
- Julie Deboer
- Dana Debusschere
All providers in Grandville, MI · Occupational Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.