Shay L Fournier, MSOT, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201013260 Issued in MI

Practice address

1300 W Houghton Lake Dr
Prudenville, MI 48651

Phone

(989) 202-2668

NPI assigned

Jun 8, 2023

Last updated

Jun 8, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Community Physical Therapy & Rehab Center Inc.

  • Physical Therapy Clinic/Center
  • West Branch, MI
  • NPI 1700924842
  NPD (past)

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1205520418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "748 W VALLEY RD",
            "city": "WEST BRANCH",
            "state": "MI",
            "postal_code": "486619706",
            "telephone_number": "989-889-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W HOUGHTON LAKE DR",
            "city": "PRUDENVILLE",
            "state": "MI",
            "postal_code": "48651",
            "telephone_number": "989-202-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURNIER",
        "first_name": "SHAY",
        "middle_name": "L",
        "credential": "MSOT, OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-06-08",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201013260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alysa Marie Fassett
• Sena Fayed
• Margaret Ficaj
• Kelley Rose Fisher
• Zachary James Fortenberry
• Ellie Fritz
• Chelsea Gabrish
• James Gee, MD
• General and Internal Medicine
• Barbara S Gielincki, FNP

• Occupational Therapist in Prudenville, MI
• Providers in Prudenville, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.