Brian P Mick, COTA

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

18-0097 Issued in KS

Practice address

4700 Indian Creek Pkwy
Overland Park, KS 66207-4068

Phone

(417) 207-9868

NPI assigned

Sep 20, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1033545173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12717 W 57TH TER",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662161608",
            "telephone_number": "316-519-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 INDIAN CREEK PKWY",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662074068",
            "telephone_number": "417-207-9868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3965 W 83rd St",
            "address_2": "Suite 233",
            "address_purpose": "LOCATION",
            "city": "Prairie Village",
            "state": "KS",
            "postal_code": "662085308",
            "country_code": "US",
            "telephone_number": "913-789-9900",
            "fax_number": "913-789-9170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICK",
        "first_name": "BRIAN",
        "middle_name": "P",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-20",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "KS",
            "license": "T-03741",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "18-0097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Occupational Therapist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.