Active NPI
Kelly Grace Trahan, OTR/L
- Occupational Therapist
- Plymouth, MI
National Provider Identifier
1316642689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201010938
- Practice address
- 40500 Ann Arbor Rd E Ste 200
Plymouth, MI 48170-4483 - Phone
- (734) 369-6002
- NPI assigned
- Apr 4, 2023
- Last updated
- Apr 4, 2023
- 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 | 5201010938 | MI | Primary |
Addresses
Primary practice location
40500 Ann Arbor Rd E Ste 200
Plymouth, MI 48170-4483
Mailing address
40500 Ann Arbor Rd E Ste 200
Plymouth, MI 48170-4483
Phone (734) 369-6002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5201010938 | MI | MD | Occupational Therapist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680566400000",
"number": "1316642689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40500 ANN ARBOR RD E STE 200",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481704483",
"telephone_number": "734-369-6002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40500 ANN ARBOR RD E STE 200",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481704483",
"telephone_number": "734-369-6002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAHAN",
"first_name": "KELLY",
"middle_name": "GRACE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-04",
"last_updated": "2023-04-04",
"certification_date": "2023-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201010938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.