Active NPI
Teresa Ann Fairgood, COTA
- Occupational Therapy Assistant
- Detroit, MI
National Provider Identifier
1427557537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5202006745
- Practice address
- 19100 W 7 Mile Rd
Detroit, MI 48219-2758 - Phone
- (313) 532-3723
- NPI assigned
- Feb 4, 2018
- 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 Therapy Assistant | 224Z00000X | 5202006745 | MI | Primary |
Addresses
Primary practice location
19100 W 7 Mile Rd
Detroit, MI 48219-2758
Mailing address
17354 Sprenger Ave
Eastpointe, MI 48021-3110
Phone (313) 408-9754
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 |
|---|---|---|---|
| 5202006745 | MI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517702400000",
"number": "1427557537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17354 SPRENGER AVE",
"city": "EASTPOINTE",
"state": "MI",
"postal_code": "480213110",
"telephone_number": "313-408-9754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19100 W 7 MILE RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482192758",
"telephone_number": "313-532-3723"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRGOOD",
"first_name": "TERESA",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-04",
"last_updated": "2018-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MI",
"license": "5202006745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.