Active NPI
Jacklyn Burnett, CTRS
- Recreation Therapist
- Farmington Hills, MI
National Provider Identifier
1972229334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 81812
- Practice address
- 25911 Middlebelt Rd
Farmington Hills, MI 48336-1402 - Phone
- (248) 471-9580
- NPI assigned
- Oct 18, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 81812 | Primary |
Addresses
Primary practice location
25911 Middlebelt Rd
Farmington Hills, MI 48336-1402
Mailing address
38716 Warwickshire Dr
Sterling Heights, MI 48312-1165
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666051200000",
"number": "1972229334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38716 WARWICKSHIRE DR",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483121165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25911 MIDDLEBELT RD",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483361402",
"telephone_number": "248-471-9580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURNETT",
"first_name": "JACKLYN",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-18",
"last_updated": "2022-10-18",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": null,
"license": "81812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.