Fawn Michelle Stender, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201006178 Issued in MI

Practice address

801 Hazen Street
Suite C
Paw Paw, MI 49079-0249

Phone

(269) 657-5574

Fax

(269) 657-3474

NPI assigned

Mar 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Fawn Michelle Bailey Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245358266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "address_2": "801 HAZEN STREET SUITE C",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490790249",
            "telephone_number": "269-657-5574",
            "fax_number": "269-657-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 HAZEN STREET",
            "address_2": "SUITE C",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490790249",
            "telephone_number": "269-657-5574",
            "fax_number": "269-657-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STENDER",
        "first_name": "FAWN",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201006178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAWN",
            "last_name": "BAILEY",
            "middle_name": "MICHELLE",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.