Individual provider Active NPI

Jennifer Jo Rosochacki, OTR

  • Occupational Therapist
  • Clinton Township, MI
National Provider Identifier
1912144627
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201000651 Issued in MI
Practice address
43650 Garfield Rd
Suite 103
Clinton Township, MI 48038-1120
Phone
(586) 228-2075
NPI assigned
Jan 16, 2009
Last updated
Jan 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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 5201000651 MI Primary

Addresses

Primary practice location

43650 Garfield Rd
Suite 103
Clinton Township, MI 48038-1120

Mailing address

46116 Springhill CT
Shelby Township, MI 48317-4052
Phone (586) 731-1422

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
5201000651MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Crawl Walk Jump Run Therapy Clinic LLC Occupational Therapist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1912144627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46116 SPRINGHILL CT",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483174052",
            "telephone_number": "586-731-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43650 GARFIELD RD",
            "address_2": "SUITE 103",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381120",
            "telephone_number": "586-228-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSOCHACKI",
        "first_name": "JENNIFER",
        "middle_name": "JO",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201000651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.