Active NPI
Nicole M Lewis, OCCUPATIONAL THERAPI
- Occupational Therapist
- Ida, MI
National Provider Identifier
1356526792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201005419
- Practice address
- 5053 Jackman Rd
Ida, MI 48140-9742 - Phone
- (734) 735-6696
- NPI assigned
- Jan 4, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 5201005419 | MI | Primary |
Addresses
Primary practice location
5053 Jackman Rd
Ida, MI 48140-9742
Mailing address
5053 Jackman Rd
Ida, MI 48140-9742
Phone (734) 735-6696
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5201005419 | MI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Essentials | Occupational Therapist | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363132800000",
"number": "1356526792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5053 JACKMAN RD",
"city": "IDA",
"state": "MI",
"postal_code": "481409742",
"telephone_number": "734-735-6696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5053 JACKMAN RD",
"city": "IDA",
"state": "MI",
"postal_code": "481409742",
"telephone_number": "734-735-6696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "NICOLE",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "OCCUPATIONAL THERAPI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-04",
"last_updated": "2013-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201005419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ida, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.