Individual provider Active NPI

Anton Ivezaj

  • Occupational Therapy Assistant
  • Shelby Township, MI
National Provider Identifier
1871066407
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Practice address
2771 Harrow Way
Shelby Township, MI 48316-1264
Phone
(248) 252-6628
NPI assigned
Jan 7, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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 Primary

Addresses

Primary practice location

2771 Harrow Way
Shelby Township, MI 48316-1264

Mailing address

2771 Harrow Way
Shelby Township, MI 48316-1264
Phone (248) 252-6628

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

NPI Registry JSON

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546819200000",
    "number": "1871066407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2771 HARROW WAY",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483161264",
            "telephone_number": "248-252-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 HARROW WAY",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483161264",
            "telephone_number": "248-252-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVEZAJ",
        "first_name": "ANTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-07",
        "last_updated": "2019-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "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 Jan 7, 2019; 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.