Mary Lisa Michael, MS, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

31001433A Issued in IN

Practice address

28100 Torch Parkway, Suite 600
West Lafayette, IN 47906

Phone

(765) 427-6171

NPI assigned

Jul 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Auburn Senior Living LLC

  dba Astral at Auburn

  • Assisted Living Facility
  • Auburn, IN
  • NPI 1437757747
  NPD (past)

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1538731260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 LANE 160 JIMMERSON LK",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467039178",
            "telephone_number": "260-243-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28100 TORCH PARKWAY, SUITE 600",
            "city": "WEST LAFAYETTE",
            "state": "IN",
            "postal_code": "47906",
            "telephone_number": "765-427-6171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 W 7th Street",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "IN",
            "postal_code": "46706",
            "country_code": "US",
            "telephone_number": "260-247-6632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "MARY",
        "middle_name": "LISA",
        "credential": "MS, OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31001433A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Melissa Mels, NP
• Kenneth Melton, ANP
• Claudia Mena
• Wendy Leeann Merrill
• Elizabeth Michael, LAT, ATC
• Cameryn Michaels
• Brooke Milburn
• Amos Robert Miller, LAC
• Ann Marie Miller, M.A.,CCC-SLP
• Brittany Yarnell Miller

• Occupational Therapist in West Lafayette, IN
• Providers in West Lafayette, IN by specialty
• Occupational Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.