Individual provider Active NPI

Faryal Shaheen

  • Occupational Therapist
  • Detroit, MI
National Provider Identifier
1184281610
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201009711 Issued in MI
Practice address
9500 Grand River Ave
Detroit, MI 48204-2132
Phone
(313) 491-7920
NPI assigned
May 21, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201009711 MI Primary

Addresses

Primary practice location

9500 Grand River Ave
Detroit, MI 48204-2132

Mailing address

9500 Grand River Ave
Detroit, MI 48204-2132

Other identifiers 1

IdentifierTypeStateIssuer
NAMedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL NA

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
5201009711MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1184281610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482042132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482042132",
            "telephone_number": "313-491-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHEEN",
        "first_name": "FARYAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NA",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "9500 Grand River Ave",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482042132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; 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.