Michelle Eileen Buck, OTR/L

Primary specialty

Low Vision Occupational TherapistTaxonomy code 225XL0004X

License

5201006345 Issued in MI

Practice address

15401 E Jefferson Ave
Grosse Pointe Park, MI 48230-1328

Phone

(313) 824-2401

NPI assigned

Feb 26, 2018

Last updated

Mar 17, 2018By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679074553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15401 E JEFFERSON AVE",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301328",
            "telephone_number": "313-824-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15401 E JEFFERSON AVE",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301328",
            "telephone_number": "313-824-2401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29200 Schoolcraft Rd",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481502228",
            "country_code": "US",
            "telephone_number": "734-523-1070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCK",
        "first_name": "MICHELLE",
        "middle_name": "EILEEN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XL0004X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Low Vision",
            "state": "MI",
            "license": "5201006345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Grosse Pointe Park, MI
• Providers in Grosse Pointe Park, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.