Individual provider Active NPI

Michelle Houser Mays, OTD, OTR, CHT

  • Occupational Therapist
  • Fort Wayne, IN
National Provider Identifier
1679758510
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31004160A Issued in IN
Practice address
6408 Constitution Dr
Fort Wayne, IN 46804-1558
Phone
(260) 433-1967
Fax
(260) 459-0282
NPI assigned
Jan 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 31004160A IN
Occupational Therapist 225X00000X 31004160A IN Primary

Addresses

Primary practice location

6408 Constitution Dr
Fort Wayne, IN 46804-1558

Mailing address

662 Chadings Dr
Roanoke, IN 46783-8875
Phone (260) 433-1967

Other practice location 1

5050 N Clinton St
Fort Wayne, IN 46825-5886
Phone (260) 484-8551

Other practice location 2

6408 Constitution Dr
Fort Wayne, IN 46804-1558
Phone (260) 433-1967

Other identifiers 2

IdentifierTypeStateIssuer
200888030MedicaidIN
11819337OtherINCAQH

Other names 1

  • Michelle A Houser Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
31004160AINMDHand Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1679758510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "662 CHADINGS DR",
            "city": "ROANOKE",
            "state": "IN",
            "postal_code": "467838875",
            "telephone_number": "260-433-1967",
            "fax_number": "260-459-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6408 CONSTITUTION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041558",
            "telephone_number": "260-433-1967",
            "fax_number": "260-459-0282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5050 N Clinton St",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468255886",
            "country_code": "US",
            "telephone_number": "260-484-8551",
            "fax_number": "260-482-5060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6408 Constitution Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468041558",
            "country_code": "US",
            "telephone_number": "260-433-1967",
            "fax_number": "260-459-0282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYS",
        "first_name": "MICHELLE",
        "middle_name": "HOUSER",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR, CHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "IN",
            "license": "31004160A",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31004160A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200888030",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11819337",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "HOUSER",
            "middle_name": "A",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.