Derek Landry, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201008526 Issued in MI

Practice address

4427 Venoy Rd
Wayne, MI 48184-1871

Phone

(734) 729-4436

NPI assigned

Jul 9, 2018

Sex

Male

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": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531094400000",
    "number": "1720574197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49222 GEDDES RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882204",
            "telephone_number": "248-330-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4427 VENOY RD",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841871",
            "telephone_number": "734-729-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "DEREK",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-09",
        "last_updated": "2018-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201008526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neelam B Kumar, MD
• Carol Kuyava, LBSW
• Christopher Lajeunesse, MD
• Sarah Lake, LLPC
• Lakeshore Kidney Care, PLLC
• Nishaya Shawnte Lang
• Tanya Lang
• Medgine Lautzenheiser
• Tyler Alise Le, MD
• Thomas E Ledesma Jr.

• Occupational Therapist in Wayne, MI
• Providers in Wayne, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.