Vicky Gail Tanana, OTR/L

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

5201002288 Issued in MI

Practice address

29800 Hoover Rd
Warren, MI 48093-3483

Phone

(586) 574-3444

NPI assigned

Apr 12, 2018

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

Other identifiers 1

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": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1811494008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 FIELDSTONE DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483091633",
            "telephone_number": "248-568-8915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29800 HOOVER RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933483",
            "telephone_number": "586-574-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANANA",
        "first_name": "VICKY",
        "middle_name": "GAIL",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "MI",
            "license": "5201002288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5201002288",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Occupational Therapist in Warren, MI
• Providers in Warren, MI by specialty
• Gerontology Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.