Active NPI
Tiffany Leeann Homant, OT
- Occupational Therapist
- Traverse City, MI
National Provider Identifier
1407155807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 1650 Barlow St
Traverse City, MI 49686-4721 - Phone
- (231) 941-3100
- Fax
- (231) 922-0382
- NPI assigned
- Mar 24, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | MI | Primary |
Addresses
Primary practice location
1650 Barlow St
Traverse City, MI 49686-4721
Mailing address
1256 Fairwood Dr
Traverse City, MI 49696-9489
Phone (231) 944-2146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43-2035142 | Other | MI | TAX ID |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300924800000",
"number": "1407155807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1256 FAIRWOOD DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496969489",
"telephone_number": "231-944-2146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 BARLOW ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496864721",
"telephone_number": "231-941-3100",
"fax_number": "231-922-0382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOMANT",
"first_name": "TIFFANY",
"middle_name": "LEEANN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-24",
"last_updated": "2011-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "43-2035142",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.