Individual provider Active NPI

Jaimie Marie Durden, OTRL

  • Occupational Therapist
  • Farmington Hills, MI
National Provider Identifier
1376069450
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201010418 Issued in MI
Practice address
30903 W 10 Mile Rd
Farmington Hills, MI 48336-2615
Phone
(248) 893-6192
NPI assigned
Aug 21, 2017
Last updated
Jan 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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 5201010418 MI Primary

Addresses

Primary practice location

30903 W 10 Mile Rd
Farmington Hills, MI 48336-2615

Mailing address

30903 W 10 Mile Rd Ste B
Farmington Hills, MI 48336-2615
Phone (248) 893-6192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190313003006 MI Practitioner - Occupational Therapist in Private Practice 2466792270 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201010418MIMDOccupational 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": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1376069450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30903 W 10 MILE RD STE B",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362615",
            "telephone_number": "248-893-6192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30903 W 10 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362615",
            "telephone_number": "248-893-6192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURDEN",
        "first_name": "JAIMIE",
        "middle_name": "MARIE",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201010418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2020; 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.

Verify at the official NPI Registry.