Individual provider Active NPI

Stacy Ann Paruch, OTR/L

  • Occupational Therapist
  • East Lansing, MI
National Provider Identifier
1932463718
Registry record updated Jun 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201007713 Issued in MI
Practice address
2111 Merritt Rd
Suite 101
East Lansing, MI 48823-6916
Phone
(517) 332-3232
Fax
(517) 332-1132
NPI assigned
Jun 27, 2012
Last updated
Jun 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2013

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 5201007713 MI Primary

Addresses

Primary practice location

2111 Merritt Rd
Suite 101
East Lansing, MI 48823-6916

Mailing address

2111 Merritt Rd
Suite 101
East Lansing, MI 48823-6916
Phone (517) 332-3232

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
5201007713MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Specialty Investments CurrentSince Apr 3, 2017 Accepting new patients
Katranji Reconstructive Surgery Institute, PLLC Occupational Therapist CurrentSince May 28, 2013 Accepting new patients

Locations

2111 Merritt Rd
Ste 101
East Lansing, MI 48823
Phone (517) 332-3232

2111 Merritt Rd
Ste 202
East Lansing, MI 48823
Phone (517) 332-4263

1055 S US Highway 27
Saint Johns, MI 48879
Phone (517) 224-3000

Organizations & group practices 2

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1932463718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 MERRITT RD",
            "address_2": "SUITE 101",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488236916",
            "telephone_number": "517-332-3232",
            "fax_number": "517-332-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 MERRITT RD",
            "address_2": "SUITE 101",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488236916",
            "telephone_number": "517-332-3232",
            "fax_number": "517-332-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARUCH",
        "first_name": "STACY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201007713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; 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.