Active NPI
Trevor Sheldon Vance, OTR/L
- Physical Rehabilitation Occupational Therapist
- Wyoming, MI
National Provider Identifier
1003614256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Rehabilitation Occupational Therapist
- License
- 5201013771
- Practice address
- 5900 Byron Center Avenue SW
Wyoming, MI 49519 - Phone
- (616) 252-7200
- NPI assigned
- Mar 4, 2025
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 5201013771 | MI | Primary |
Addresses
Primary practice location
5900 Byron Center Avenue SW
Wyoming, MI 49519
Mailing address
643 Marietta St NE
Grand Rapids, MI 49505
Phone (231) 590-2246
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5201013771 | MI | MD | Physical Rehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1741046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741046400000",
"number": "1003614256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "643 MARIETTA ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49505",
"telephone_number": "231-590-2246"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 BYRON CENTER AVENUE SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "49519",
"telephone_number": "616-252-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANCE",
"first_name": "TREVOR",
"middle_name": "SHELDON",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-04",
"last_updated": "2025-03-04",
"certification_date": "2025-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "MI",
"license": "5201013771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.