Individual provider Active NPI

Sharon Elizabeth Roberts

  • Occupational Therapist
  • Saint Joseph, MI
National Provider Identifier
1235608274
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201001245 Issued in MI
Practice address
3950 Hollywood Rd
Saint Joseph, MI 49085-9159
Phone
(269) 556-7120
Fax
(269) 556-7120
NPI assigned
Nov 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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 5201001245 MI Primary

Addresses

Primary practice location

3950 Hollywood Rd
Saint Joseph, MI 49085-9159

Mailing address

3950 Hollywood Rd Ste 218
Saint Joseph, MI 49085-9151
Phone (269) 556-7120

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

State licenses

LicenseStateTypeSpecialty
5201001245MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeland Hospitals at Niles and St Joseph, Inc Past Accepting new patients
Lakeland Hospitals at Niles and St Joseph, Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1235608274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD STE 218",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859151",
            "telephone_number": "269-556-7120",
            "fax_number": "269-556-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 HOLLYWOOD RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859159",
            "telephone_number": "269-556-7120",
            "fax_number": "269-556-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "SHARON",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201001245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.

Verify at the official NPI Registry.