Mary Ellen Bardyga, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201003179 Issued in MI

Practice address

6470 Alden Dr
Orchard Lake, MI 48324-2006

Phone

(248) 363-4121

NPI assigned

Mar 7, 2018

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1699277434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6470 ALDEN DR",
            "city": "ORCHARD LAKE",
            "state": "MI",
            "postal_code": "483242006",
            "telephone_number": "248-363-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6470 ALDEN DR",
            "city": "ORCHARD LAKE",
            "state": "MI",
            "postal_code": "483242006",
            "telephone_number": "248-363-4121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 Spring St",
            "address_purpose": "LOCATION",
            "city": "Petoskey",
            "state": "MI",
            "postal_code": "497709295",
            "country_code": "US",
            "telephone_number": "231-347-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22811 W 7 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482191739",
            "country_code": "US",
            "telephone_number": "313-534-1440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Ford St",
            "address_purpose": "LOCATION",
            "city": "Highland Park",
            "state": "MI",
            "postal_code": "482033622",
            "country_code": "US",
            "telephone_number": "313-883-3585",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10770 Elizabeth Lake Rd",
            "address_purpose": "LOCATION",
            "city": "White Lake",
            "state": "MI",
            "postal_code": "483862136",
            "country_code": "US",
            "telephone_number": "248-618-4100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "46100 Schoenherr Rd",
            "address_purpose": "LOCATION",
            "city": "Shelby Township",
            "state": "MI",
            "postal_code": "483155344",
            "country_code": "US",
            "telephone_number": "586-566-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6445 W Maple Rd",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483222047",
            "country_code": "US",
            "telephone_number": "248-661-1600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1255 W Silverbell Rd",
            "address_purpose": "LOCATION",
            "city": "Orion",
            "state": "MI",
            "postal_code": "483591345",
            "country_code": "US",
            "telephone_number": "248-391-0900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11700 E 10 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480893903",
            "country_code": "US",
            "telephone_number": "586-759-5960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARDYGA",
        "first_name": "MARY ELLEN",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201003179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Orchard Lake, MI
• Providers in Orchard Lake, 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.