Individual provider Active NPI

Kristine A Siemer, OTR/L, CHT

  • Occupational Therapist
  • Traverse City, MI
National Provider Identifier
1013418110
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201001178 Issued in MI
Practice address
1105 Sixth St
Traverse City, MI 49684-2345
Phone
(231) 935-8600
NPI assigned
Feb 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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 5201001178 MI Primary

Addresses

Primary practice location

1105 Sixth St
Traverse City, MI 49684-2345

Mailing address

2099 Chrystal Ridge Dr
Traverse City, MI 49686-9174

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
5201001178MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1519344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1013418110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2099 CHRYSTAL RIDGE DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496869174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SIXTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842345",
            "telephone_number": "231-935-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEMER",
        "first_name": "KRISTINE",
        "middle_name": "A",
        "credential": "OTR/L, CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-23",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201001178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; 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.