NPIMap

Individual provider Active NPI

Michelle St. Marie, OT

  • Occupational Therapist
  • Cullman, AL
National Provider Identifier
1205196631
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT3385 Issued in AL
Practice address
1701 Main Ave SW
Suite G
Cullman, AL 35055-5299
Phone
(256) 775-3737
Fax
(256) 775-3738
NPI assigned
May 18, 2012
Last updated
May 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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 OT3385 AL Primary

Addresses

Primary practice location

1701 Main Ave SW
Suite G
Cullman, AL 35055-5299

Mailing address

1908 Flint Rd SE
Decatur, AL 35601-6031
Phone (256) 340-9708

Other identifiers 2

IdentifierTypeStateIssuer
1003819608OtherALGROUP NPI
529917620MedicaidAL

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Encore Rehabilitation, Inc PastSince Oct 20, 2014 Accepting new patients
Encore Rehabilitation, Inc. Past Accepting new patients
Encore Rehabilitation, Inc. Occupational Therapist Past Accepting new patients
Encore Rehabilitation, Inc. Past Accepting new patients
Encore Rehabilitation Inc Past Accepting new patients

Organizations & group practices 5

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": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337299200000",
    "number": "1205196631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 FLINT RD SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356016031",
            "telephone_number": "256-340-9708",
            "fax_number": "256-340-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 MAIN AVE SW",
            "address_2": "SUITE G",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350555299",
            "telephone_number": "256-775-3737",
            "fax_number": "256-775-3738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. MARIE",
        "first_name": "MICHELLE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-18",
        "last_updated": "2012-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AL",
            "license": "OT3385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1003819608",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529917620",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; 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.