Active NPI
Maddison Maree Menna
- Occupational Therapist
- Woodhaven, MI
National Provider Identifier
1669118162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201012961
- Practice address
- 18500 Van Horn Rd
Woodhaven, MI 48183-3803 - Phone
- (734) 676-7575
- NPI assigned
- May 7, 2022
- 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 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Environmental Modification Occupational Therapist | 225XE0001X | 5201012961 | MI | |
| Feeding, Eating & Swallowing Occupational Therapist | 225XF0002X | 5201012961 | MI | |
| Gerontology Occupational Therapist | 225XG0600X | 5201012961 | MI | |
| Hand Occupational Therapist | 225XH1200X | 5201012961 | MI | |
| Human Factors Occupational Therapist | 225XH1300X | 5201012961 | MI | |
| Low Vision Occupational Therapist | 225XL0004X | 5201012961 | MI | |
| Mental Health Occupational Therapist | 225XM0800X | 5201012961 | MI | |
| Neurorehabilitation Occupational Therapist | 225XN1300X | 5201012961 | MI | |
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 5201012961 | MI | |
| Pediatric Occupational Therapist | 225XP0200X | 5201012961 | MI | |
| Driving and Community Mobility Occupational Therapist | 225XR0403X | 5201012961 | MI | |
| Occupational Therapist | 225X00000X | 5201012961 | MI | Primary |
Addresses
Primary practice location
18500 Van Horn Rd
Woodhaven, MI 48183-3803
Mailing address
351 Truax St
Trenton, MI 48183-2120
Phone (734) 931-2300
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 |
|---|---|---|---|
| 5201012961 | MI | MD | Environmental Modification Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651881600000",
"number": "1669118162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "351 TRUAX ST",
"city": "TRENTON",
"state": "MI",
"postal_code": "481832120",
"telephone_number": "734-931-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18500 VAN HORN RD",
"city": "WOODHAVEN",
"state": "MI",
"postal_code": "481833803",
"telephone_number": "734-676-7575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENNA",
"first_name": "MADDISON",
"middle_name": "MAREE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-07",
"last_updated": "2022-05-07",
"certification_date": "2022-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "225XE0001X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Environmental Modification",
"state": "MI",
"license": "5201012961",
"primary": false
},
{
"code": "225XF0002X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Feeding, Eating & Swallowing",
"state": "MI",
"license": "5201012961",
"primary": false
},
{
"code": "225XG0600X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Gerontology",
"state": "MI",
"license": "5201012961",
"primary": false
},
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "MI",
"license": "5201012961",
"primary": false
},
{
"code": "225XH1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Human Factors",
"state": "MI",
"license": "5201012961",
"primary": false
},
{
"code": "225XL0004X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Low Vision",
"state": "MI",
"license": "5201012961",
"primary": false
},
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": "MI",
"license": "5201012961",
"primary": false
},
{
"code": "225XN1300X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": "MI",
"license": "5201012961",
"primary": false
},
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "MI",
"license": "5201012961",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "MI",
"license": "5201012961",
"primary": false
},
{
"code": "225XR0403X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Driving and Community Mobility",
"state": "MI",
"license": "5201012961",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201012961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodhaven, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.