Active NPI
Jessica Ridenour, OTR/L
- Occupational Therapist
- Troy, MI
National Provider Identifier
1215406608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201009846
- Practice address
- 925 W South Blvd
Troy, MI 48085-1502 - Phone
- (248) 729-4491
- NPI assigned
- Nov 15, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201009846 | MI | Primary |
Addresses
Primary practice location
925 W South Blvd
Troy, MI 48085-1502
Mailing address
925 W South Blvd
Troy, MI 48085-1502
Phone (248) 729-4491
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5201009846 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542240000000",
"number": "1215406608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 W SOUTH BLVD",
"city": "TROY",
"state": "MI",
"postal_code": "480851502",
"telephone_number": "248-729-4491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 W SOUTH BLVD",
"city": "TROY",
"state": "MI",
"postal_code": "480851502",
"telephone_number": "248-729-4491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIDENOUR",
"first_name": "JESSICA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-15",
"last_updated": "2018-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201009846",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.