Crystal L Douglas, MOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201008124 Issued in MI

Practice address

2986 Roundtree Blvd
Ypsilanti, MI 48197-4811

Phone

(810) 624-2630

NPI assigned

Aug 15, 2018

Last updated

Sep 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• JH Therapy Services

  • Occupational Therapist
  • Lapeer, MI
  • NPI 1104618180
  Medicare reassignment

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1508346073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 E REID RD APT 12",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2986 ROUNDTREE BLVD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481974811",
            "telephone_number": "810-624-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "CRYSTAL",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201008124",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Dorsey, MD
• Sandra L Doud, O.D.
• Emilianne Dougall, NP-C
• Olivia M Doughty, CTRS
• Douglas a Hock, DDS, Ms PC
• Christine Doyle, LLMSW
• Constance J Doyle, MD
• Dr Naz DDS PC
• Donald Charles Drake III
• Latoya Chavonne Drake

• Occupational Therapist in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.