Active NPI
Jessica Ravineala, OTR/L
- Pediatric Occupational Therapist
- Farmington Hills, MI
National Provider Identifier
1447531769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 5201008046
- Practice address
- 25882 Orchard Lake Rd
Suite 207B
Farmington Hills, MI 48336-1292 - Phone
- (616) 890-6997
- NPI assigned
- Aug 31, 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 5201008046 | MI | Primary |
Addresses
Primary practice location
25882 Orchard Lake Rd
Suite 207B
Farmington Hills, MI 48336-1292
Mailing address
25882 Orchard Lake Rd
Suite 207B
Farmington Hills, MI 48336-1292
Phone (616) 890-6997
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5201008046 | MI | MD | Pediatric Occupational Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Occupational Therapist
- Farmington Hills, MI
- NPI 1184038341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403827200000",
"number": "1447531769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25882 ORCHARD LAKE RD",
"address_2": "SUITE 207B",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483361292",
"telephone_number": "616-890-6997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25882 ORCHARD LAKE RD",
"address_2": "SUITE 207B",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483361292",
"telephone_number": "616-890-6997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAVINEALA",
"first_name": "JESSICA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-31",
"last_updated": "2014-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "MI",
"license": "5201008046",
"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 Jun 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.