Individual provider Active NPI

Amrit Haelen Khalsa

  • Occupational Therapist
  • Macomb, MI
National Provider Identifier
1174098818
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201010271 Issued in MI
Practice address
15959 Hall Rd Ste 410
Macomb, MI 48044-5365
Phone
(586) 416-6290
NPI assigned
Oct 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 5201010271 MI Primary

Addresses

Primary practice location

15959 Hall Rd Ste 410
Macomb, MI 48044-5365

Mailing address

490 Academy St
Ferndale, MI 48220-2821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5201010271MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1174098818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 ACADEMY ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15959 HALL RD STE 410",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480445365",
            "telephone_number": "586-416-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALSA",
        "first_name": "AMRIT",
        "middle_name": "HAELEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201010271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.