Individual provider Active NPI

Sally Ann Schulman

  • Occupational Therapist
  • Royal Oak, MI
National Provider Identifier
1164712477
Registry record updated Nov 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201002884 Issued in MI
Practice address
317 E 11 Mile Rd
Royal Oak, MI 48067-2735
Phone
(248) 336-2868
Fax
(248) 336-2879
NPI assigned
Apr 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801104919 MI
Occupational Therapist 225X00000X 5201002884 MI Primary

Addresses

Primary practice location

317 E 11 Mile Rd
Royal Oak, MI 48067-2735

Mailing address

PO Box 856
Antioch, IL 60002-0856
Phone (847) 903-5604

Other practice location 1

3694 Clarkston Rd Ste C
Clarkston, MI 48348-5213
Phone (847) 903-5604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801104919MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Spiritual Fitness LLC Clinical Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1164712477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 856",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600020856",
            "telephone_number": "847-903-5604",
            "fax_number": "224-788-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 E 11 MILE RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672735",
            "telephone_number": "248-336-2868",
            "fax_number": "248-336-2879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3694 Clarkston Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "MI",
            "postal_code": "483485213",
            "country_code": "US",
            "telephone_number": "847-903-5604",
            "fax_number": "224-788-5112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHULMAN",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-08",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801104919",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201002884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.