Kristin Suzanne Beauvais, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201006837 Issued in MI

Practice address

261 Mack Ave
Detroit, MI 48201-2495

Phone

(313) 745-1055

NPI assigned

Jun 4, 2018

Last updated

Dec 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehabilitation Services Mi LLCGroup PAC ID 2769819960, 84 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fox Rehabilitation Services Mi LLC

  dba Fox Rehabilitation

  • Physical Therapist
  • Canton, MI
  • NPI 1790324648

  Occupational Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1922590165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012495",
            "telephone_number": "313-745-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012495",
            "telephone_number": "313-745-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUVAIS",
        "first_name": "KRISTIN",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201006837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation Services MI LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "5969 N Canton Center Rd",
            "city": "Canton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481872757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole Beatty, CENA
• Elexus Beauchamp
• Erin Elizabeth Beaudoin
• Linda Ann Beauregard
• Beauty of Homes LLC
• Dalieo M Beaver II
• Erica Marie Beavers, DNP-FNP
• Jacqueline Maria Beavers, LMSW
• Sylvia Beavers
• Tea Beba, LMSW

• Occupational Therapist in Detroit, MI
• Providers in Detroit, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.