Individual provider Active NPI

Christopher Mitchell

  • Occupational Therapy Assistant
  • Fenton, MI
National Provider Identifier
1265845580
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5202004101 Issued in MI
Practice address
315 Georgetown Pkwy
Fenton, MI 48430-3215
Phone
(248) 770-0194
NPI assigned
Jun 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5202004101 MI Primary

Addresses

Primary practice location

315 Georgetown Pkwy
Fenton, MI 48430-3215

Mailing address

315 Georgetown Pkwy
Fenton, MI 48430-3215

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

LicenseStateTypeSpecialty
5202004101MIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1265845580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 GEORGETOWN PKWY",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 GEORGETOWN PKWY",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303215",
            "telephone_number": "248-770-0194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CHRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MI",
            "license": "5202004101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.