Active NPI
Elishia Licavoli, O.T.R.L.
- Occupational Therapist
- Bay City, MI
National Provider Identifier
1225316698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 3707 Katalin Court
Bay City, MI 48706-2161 - Phone
- (989) 671-0866
- Fax
- (989) 671-0867
- NPI assigned
- Aug 2, 2011
- 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 | Primary |
Addresses
Primary practice location
3707 Katalin Court
Bay City, MI 48706-2161
Mailing address
3707 Katalin Court
Bay City, MI 48706-2161
Phone (989) 671-0866
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David a. Wiersema, D.O., PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- Saginaw, MI
- NPI 1154572972
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312243200000",
"number": "1225316698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3707 KATALIN COURT",
"city": "BAY CITY",
"state": "MI",
"postal_code": "487062161",
"telephone_number": "989-671-0866",
"fax_number": "989-671-0867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3707 KATALIN COURT",
"city": "BAY CITY",
"state": "MI",
"postal_code": "487062161",
"telephone_number": "989-671-0866",
"fax_number": "989-671-0867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICAVOLI",
"first_name": "ELISHIA",
"name_prefix": "Ms.",
"credential": "O.T.R.L.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-02",
"last_updated": "2011-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bay City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.