Individual provider Active NPI

Adam John Williams, COTA

  • Occupational Therapy Assistant
  • Shelby Township, MI
National Provider Identifier
1861637696
Registry record updated Dec 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5202007083 Issued in MI
Practice address
14145 Simone Dr
Shelby Township, MI 48315-3228
Phone
(586) 566-6280
NPI assigned
Dec 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5202007083 MI Primary

Addresses

Primary practice location

14145 Simone Dr
Shelby Township, MI 48315-3228

Mailing address

21807 Blackburn St
Saint Clair Shores, MI 48080-3901
Phone (586) 943-8074

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
5202007083MIMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Developing Connections, Inc. PastSince May 3, 2012 Accepting new patients
Developing Connections Inc. Past 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": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228694400000",
    "number": "1861637696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21807 BLACKBURN ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803901",
            "telephone_number": "586-943-8074"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ADAM",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-08",
        "last_updated": "2008-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MI",
            "license": "5202007083",
            "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 Dec 8, 2008; 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.