Individual provider Active NPI

Kendra Ross, OT

  • Occupational Therapist
  • Canton, MI
National Provider Identifier
1417317850
Registry record updated Feb 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201002242 Issued in MI
Practice address
44560 Westminister Way
Canton, MI 48187-2649
Phone
(734) 865-0116
NPI assigned
Feb 27, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2016

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 5201002242 MI Primary

Addresses

Primary practice location

44560 Westminister Way
Canton, MI 48187-2649

Mailing address

44560 Westminister Way
Canton, MI 48187-2649
Phone (734) 865-0116

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
5201002242MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1456531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456531200000",
    "number": "1417317850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44560 WESTMINISTER WAY",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872649",
            "telephone_number": "734-865-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44560 WESTMINISTER WAY",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872649",
            "telephone_number": "734-865-0116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "KENDRA",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-27",
        "last_updated": "2016-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201002242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2016; 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.