Individual provider Active NPI

Alyssa Visockis

  • Occupational Therapist
  • Plymouth, MI
National Provider Identifier
1689495004
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201013947 Issued in MI
Practice address
851 Penniman Ave
Plymouth, MI 48170-1621
Phone
(248) 349-9595
Fax
(989) 509-5965
NPI assigned
Oct 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201013947 MI Primary

Addresses

Primary practice location

851 Penniman Ave
Plymouth, MI 48170-1621

Mailing address

851 Penniman Ave
Plymouth, MI 48170-1621
Phone (248) 349-9595

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

NPI Registry JSON

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1689495004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 PENNIMAN AVE",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701621",
            "telephone_number": "248-349-9595",
            "fax_number": "989-509-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 PENNIMAN AVE",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701621",
            "telephone_number": "248-349-9595",
            "fax_number": "989-509-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISOCKIS",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201013947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.