Courtney Lynn Fankhauser, CTRS

Primary specialty

Recreation TherapistTaxonomy code 225800000X

License

59551 Issued in NU

Practice address

10909 Hannan Rd
Romulus, MI 48174-1383

Phone

(734) 893-1080

NPI assigned

Jun 1, 2011

Last updated

Aug 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Courtney Riehle Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1558655001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 VIVIAN RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481624133",
            "telephone_number": "419-367-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10909 HANNAN RD",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481741383",
            "telephone_number": "734-893-1080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2255 Vivian Rd",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "MI",
            "postal_code": "481624133",
            "country_code": "US",
            "telephone_number": "419-367-3075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANKHAUSER",
        "first_name": "COURTNEY",
        "middle_name": "LYNN",
        "credential": "CTRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-01",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "NU",
            "license": "59551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "RIEHLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Recreation Therapist in Romulus, MI
• Providers in Romulus, MI by specialty
• Recreation Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.