Individual provider Active NPI

Phylis Moehlman

  • Occupational Therapist
  • Novi, MI
National Provider Identifier
1417406463
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201005532 Issued in MI
Practice address
41215 Fox Run
Novi, MI 48377-4803
Phone
(248) 668-8655
NPI assigned
Sep 30, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 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 5201005532 MI Primary

Addresses

Primary practice location

41215 Fox Run
Novi, MI 48377-4803

Mailing address

45625 S Lake Dr
Novi, MI 48377-3920

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
5201005532MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1417406463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45625 S LAKE DR",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483773920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41215 FOX RUN",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483774803",
            "telephone_number": "248-668-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEHLMAN",
        "first_name": "PHYLIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201005532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.