Active NPI
Lisa Johnson
- Pediatric Occupational Therapist
- Farmington Hills, MI
National Provider Identifier
1407061401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 5201003959
- Practice address
- 25465 Kilreigh Dr
Farmington Hills, MI 48336-1548 - Phone
- (248) 471-2297
- NPI assigned
- May 11, 2007
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 5201003959 | MI | Primary |
Addresses
Primary practice location
25465 Kilreigh Dr
Farmington Hills, MI 48336-1548
Mailing address
25465 Kilreigh Dr
Farmington Hills, MI 48336-1548
Phone (248) 471-2297
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5201003959 | MI | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407061401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25465 KILREIGH DR",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483361548",
"telephone_number": "248-471-2297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25465 KILREIGH DR",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483361548",
"telephone_number": "248-471-2297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "MI",
"license": "5201003959",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.