Bryony Fawne Derose, OTR
NPI 1689875841ActiveIndividual· Occupational Therapist, Hand· Dearborn, MI
Occupational Therapist, Hand (OTR) with Athletico Ltd, practicing in Dearborn, Michigan. Enrolled in Medicare as practitioner - occupational therapist in private practice.
Overview
| NPI | 1689875841 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | OTR |
| Sole proprietor | No |
| NPI issued | May 29, 2007 |
| Last updated in NPPES | Feb 19, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Occupational Therapist, Hand Primary | 225XH1200X | 5201005966 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Occupational Therapist in Private Practice (MI) |
|---|
Education and affiliations
| Graduation year | 2001 |
|---|---|
| Medicare specialty | Occupational Therapist In Private Practice |
Medical group
- Athletico LtdOttawa, IL · 2,200 clinicians
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