Individual provider Active NPI

Jodie Carley, OTR/L

  • Occupational Therapist
  • Troy, MI
National Provider Identifier
1942695341
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201009117 Issued in MI
Practice address
210 Town Center Dr
Troy, MI 48084-1774
Phone
(248) 643-8900
Fax
(248) 740-3505
NPI assigned
Apr 2, 2015
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X NU
Occupational Therapist 225X00000X 5201009117 MI Primary

Addresses

Primary practice location

210 Town Center Dr
Troy, MI 48084-1774

Mailing address

23948 Cora Ave
Farmington Hills, MI 48336-2624
Phone (148) 760-7543

Other practice location 1

5210 Highland Rd
Suite 100
Waterford, MI 48327-1970
Phone (248) 674-9560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150421000244 MI Practitioner - Occupational Therapist in Private Practice 9537487640 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Behavioral Outcomes Management,LLCGroup PAC ID 1355602426, 18 clinicians

Practice addresses (Care Compare)

210 Town Ctr Dr
Troy, MI 48084-1774
Phone (248) 643-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201009117MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Outcomes Management,LLC Occupational Therapist CurrentSince Jan 15, 2018 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville, LLC CurrentSince Apr 2, 2015 Accepting new patients
Michigan Rehabilitation Specialists of Fowlerville LLC Occupational Therapist CurrentSince Apr 2, 2015 Accepting new patients

Locations

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

5700 Jackson Rd
Ann Arbor, MI 48103
Phone (734) 926-4710

210 Town Center Dr
Troy, MI 48084
Phone (248) 643-8900

5210 Highland Rd
Ste 100
Waterford, MI 48327
Phone (248) 674-9560

Organizations & group practices 3

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": "1427932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1942695341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23948 CORA AVE",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362624",
            "telephone_number": "148-760-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 TOWN CENTER DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480841774",
            "telephone_number": "248-643-8900",
            "fax_number": "248-740-3505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5210 Highland Rd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "MI",
            "postal_code": "483271970",
            "country_code": "US",
            "telephone_number": "248-674-9560",
            "fax_number": "248-674-9562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLEY",
        "first_name": "JODIE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.