Jacqueline Tiernan, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201012677 Issued in MI

Practice address

3200 E Eisenhower Pkwy
Ann Arbor, MI 48108-3231

Phone

(734) 677-0070

NPI assigned

Oct 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jacqueline Whitus Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moriah, IncorporatedGroup PAC ID 1456539337, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Moriah, Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ann Arbor, MI
  • NPI 1558544130
  Medicare reassignment Care Compare group NPD
• Comprehensive Speech and Therapy Center, Inc

  • Behavior Analyst
  • Jackson, MI
  • NPI 1447848049
  NPD
• Comprehensive Speech and Therapy Center, Inc

  • Rehabilitation Clinic/Center
  • Jackson, MI
  • NPI 1457473480
  NPD (past)

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1912660689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481066069",
            "telephone_number": "248-202-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 E EISENHOWER PKWY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083231",
            "telephone_number": "734-677-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNAN",
        "first_name": "JACQUELINE",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-19",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201012677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jackie@therapyjackson.com",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1001 Laurence Ave Ste E",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492022980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "WHITUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anti'Shay Thurman, LLMSW
• Judith Louise Thurman, LMSW
• Courtney Megan Thurston, LPC
• Michelle Devereux Tibbs, MD
• Paul K Tichenor, MD
• Clara Tift, MD
• Averie Lynn Tigges, MD
• Sugandha Tijoriwala, CNP
• Raisa Tikhtman, MD
• Sara Renee Till, MD

• Occupational Therapist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.