Individual provider Active NPI

Shannon Leitermann

  • Occupational Therapist
  • Saginaw, MI
National Provider Identifier
1740768787
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201010111 Issued in MI
Practice address
700 Cooper Ave
Saginaw, MI 48602-5383
Phone
(989) 583-0000
NPI assigned
Aug 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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 5201010111 MI Primary

Addresses

Primary practice location

700 Cooper Ave
Saginaw, MI 48602-5383

Mailing address

4072 Richlyn CT
Bay City, MI 48706-2431

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5201010111MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1740768787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4072 RICHLYN CT",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487062431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 COOPER AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486025383",
            "telephone_number": "989-583-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITERMANN",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201010111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.