Individual provider Active NPI

Louise Fragnoli

  • Feeding, Eating & Swallowing Occupational Therapy Assistant
  • Saint Clair Shores, MI
National Provider Identifier
1396235388
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Feeding, Eating & Swallowing Occupational Therapy AssistantTaxonomy code 224ZF0002X
License
5201005385 Issued in MI
Practice address
26001 Jefferson Ave
Saint Clair Shores, MI 48081-2309
Phone
(586) 779-7000
NPI assigned
May 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Feeding, Eating & Swallowing Occupational Therapy Assistant 224ZF0002X 5201005385 MI Primary

Addresses

Primary practice location

26001 Jefferson Ave
Saint Clair Shores, MI 48081-2309

Mailing address

47905 Freedom Valley Dr
Macomb, MI 48044-2597
Phone (586) 779-7000

Other identifiers 1

IdentifierTypeStateIssuer
5201005385MedicaidMI

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5201005385MIMDFeeding, Eating & Swallowing Occupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1396235388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47905 FREEDOM VALLEY DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480442597",
            "telephone_number": "586-779-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26001 JEFFERSON AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812309",
            "telephone_number": "586-779-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAGNOLI",
        "first_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Feeding, Eating & Swallowing",
            "state": "MI",
            "license": "5201005385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5201005385",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.