Individual provider Active NPI

Michael Dahm

  • Occupational Therapist
  • Dearborn, MI
National Provider Identifier
1366989451
Registry record updated Jan 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201009600 Issued in MI
Practice address
23400 Michigan Ave
Suite P40
Dearborn, MI 48124-1924
Phone
(313) 689-5188
NPI assigned
Jan 26, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2017

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 5201009600 MI Primary

Addresses

Primary practice location

23400 Michigan Ave
Suite P40
Dearborn, MI 48124-1924

Mailing address

2111 Cliffside Dr
Wixom, MI 48393-1276
Phone (414) 236-9576

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
5201009600MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1485388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1366989451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 CLIFFSIDE DR",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483931276",
            "telephone_number": "414-236-9576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23400 MICHIGAN AVE",
            "address_2": "SUITE P40",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241924",
            "telephone_number": "313-689-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHM",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-26",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; 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.