NPIMap

Tiffany Afton

Individual provider Active NPI Occupational Therapist · Grand Rapids, MI

NPI 1376017939 · NPPES record last updated Jan 17, 2019

Key facts

NPI
1376017939
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
5201005613 (MI)
Practice address
1430 Monroe Ave NW Ste 120
Grand Rapids, MI 49505-4678
Phone
(616) 685-8800
NPI assigned
Jan 17, 2019
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5201005613MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Mary'S Amicare Home Healthcare Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201005613 MI Yes

Addresses

Primary practice location

1430 Monroe Ave NW Ste 120
Grand Rapids, MI 49505-4678

Mailing address

19518 3 Mile Rd
Morley, MI 49336-9565

Other identifiers

IdentifierTypeStateIssuer
5201005613MedicaidMI

Other providers in Grand Rapids, MI

All providers in Grand Rapids, MI · Occupational Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.