MRS. ANNETTA HARDAMON OT
NPI 1104411040
Occupational Therapist - Physical Rehabilitation in Southfield, MI
About Mrs. Annetta Hardamon Ot NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. ANNETTA HARDAMON OT (NPI 1104411040) is an individual physical rehabilitation provider in Southfield, Michigan, licensed in Michigan (5201000367) and active in the NPI registry since March 2021. She is a graduate of Wayne State University School Of Medicine (1984).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mrs. Annetta Hardamon Ot is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Annetta Hardamon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Southfield, MI 48034
- Reassigned Medicare billing, Michigan enrollment
- 2 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48034 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Annetta Hardamon's NPI number?
The NPI number for Annetta Hardamon is 1104411040. It was assigned to this individual provider in the NPPES registry on March 3, 2021.
Where is Annetta Hardamon located?
Annetta Hardamon practices at 26776 W 12 Mile Rd Ste 101, Southfield, MI 48034. The listed phone number is (248) 450-3183.
What is Annetta Hardamon's specialty?
The primary specialty registered for this NPI is Occupational Therapist, specializing in Physical Rehabilitation, with taxonomy code 225XP0019X.
Is Annetta Hardamon enrolled in Medicare?
Yes. Annetta Hardamon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Annetta Hardamon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Annetta Hardamon reassigns Medicare benefits to Ats Physical Therapy PLLC (Southfield, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Annetta Hardamon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Annetta Hardamon was last updated on March 3, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mrs. Annetta Hardamon, OT · NPI 1104411040
Physical Rehabilitation provider in Southfield, Michigan. Individual provider, active in the CMS NPPES registry since March 3, 2021.
## Identity
- **NPI:** 1104411040 (Entity type: Individual)
- **Enumerated:** March 3, 2021
- **Primary specialty:** Occupational Therapist - Physical Rehabilitation · taxonomy 225XP0019X
- **State license:** 5201000367 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 26776 W 12 MILE RD STE 101, Southfield, MI 48034-7807
- **Phone:** (248) 450-3183
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Bills Medicare through:** Ats Physical Therapy PLLC (NPI 1508417106, Southfield, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Wayne State University School Of Medicine, class of 1984
## Record status
- **NPPES last updated:** March 3, 2021
---
Source: [NPI Profile](https://npiprofile.com/npi/1104411040) · Data from the CMS NPPES public registry.