Active NPI
Mari Sharp Roach, C.O.T.A.
- Occupational Therapy Assistant
- Columbiaville, MI
National Provider Identifier
1912274739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5202006119
- Practice address
- 833 Woodlawn Drive
Columbiaville, MI 48421 - Phone
- (810) 793-1819
- NPI assigned
- Nov 22, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5202006119 | MI | Primary |
| Occupational Therapy Assistant | 224Z00000X | 1041682 | MI |
Addresses
Primary practice location
833 Woodlawn Drive
Columbiaville, MI 48421
Mailing address
833 Woodlawn Drive
Columbiaville, MI 48421
Phone (810) 793-1819
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1041682 | MI | MD | Occupational Therapy Assistant |
| 5202006119 | MI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1321920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321920000000",
"number": "1912274739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 WOODLAWN DRIVE",
"city": "COLUMBIAVILLE",
"state": "MI",
"postal_code": "48421",
"telephone_number": "810-793-1819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "833 WOODLAWN DRIVE",
"city": "COLUMBIAVILLE",
"state": "MI",
"postal_code": "48421",
"telephone_number": "810-793-1819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROACH",
"first_name": "MARI",
"middle_name": "SHARP",
"name_prefix": "Mrs.",
"credential": "C.O.T.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-22",
"last_updated": "2011-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MI",
"license": "5202006119",
"primary": true
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MI",
"license": "1041682",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbiaville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.