Individual provider Active NPI

Deborah E. Ruediger, O.T.

  • Occupational Therapist
  • Grand Rapids, MI
National Provider Identifier
1003292053
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201006731 Issued in MI
Practice address
3000 Monroe Ave NE
Grand Rapids, MI 49505-3313
Phone
(877) 864-8171
NPI assigned
Jul 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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 5201006731 MI Primary

Addresses

Primary practice location

3000 Monroe Ave NE
Grand Rapids, MI 49505-3313

Mailing address

851 Penniman Ave
Plymouth, MI 48170-1621
Phone (877) 864-8171

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

State licenses

LicenseStateTypeSpecialty
5201006731MIMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1003292053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 PENNIMAN AVE",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701621",
            "telephone_number": "877-864-8171",
            "fax_number": "989-509-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MONROE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495053313",
            "telephone_number": "877-864-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUEDIGER",
        "first_name": "DEBORAH",
        "middle_name": "E.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201006731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.