Active NPI
Kimberly Ranee Withers, BS, COTAL
- Occupational Therapy Assistant
- Grand Rapids, MI
National Provider Identifier
1033768122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5201005189
- Practice address
- 1700 Leonard St NE
Grand Rapids, MI 49505-5636 - Phone
- (616) 456-7243
- NPI assigned
- Sep 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5201005189 | MI | Primary |
Addresses
Primary practice location
1700 Leonard St NE
Grand Rapids, MI 49505-5636
Mailing address
1700 Leonard St NE
Grand Rapids, MI 49505-5636
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5201005189 | MI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568073600000",
"number": "1033768122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 LEONARD ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495055636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 LEONARD ST NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495055636",
"telephone_number": "616-456-7243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITHERS",
"first_name": "KIMBERLY",
"middle_name": "RANEE",
"credential": "BS, COTAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-10",
"last_updated": "2019-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MI",
"license": "5201005189",
"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 Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.