Individual provider Active NPI

Elizabeth Stewart

  • Occupational Therapist
  • Shelby Township, MI
National Provider Identifier
1821540873
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201006876 Issued in MI
Practice address
14145 Simone Dr
Shelby Township, MI 48315-3228
Phone
(586) 566-6280
Fax
(586) 566-1898
NPI assigned
Oct 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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 5201006876 MI Primary

Addresses

Primary practice location

14145 Simone Dr
Shelby Township, MI 48315-3228

Mailing address

14145 Simone Dr
Shelby Township, MI 48315-3228
Phone (586) 566-6280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161227000908 MI Practitioner - Occupational Therapist in Private Practice 0446531883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Wayne State University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Developing Connections, IncGroup PAC ID 7315103850, 4 clinicians

Practice addresses (Care Compare)

14145 Simone Dr
Shelby Township, MI 48315-3228
Phone (586) 566-6280

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201006876MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Developing Connections Inc. PastSince Nov 14, 2016 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1821540873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14145 SIMONE DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153228",
            "telephone_number": "586-566-6280",
            "fax_number": "586-566-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14145 SIMONE DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483153228",
            "telephone_number": "586-566-6280",
            "fax_number": "586-566-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-25",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201006876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.