Active NPI
Amanda Grycki, OTR/L
- Occupational Therapist
- Newaygo, MI
National Provider Identifier
1053814566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201009877
- Practice address
- 1 State Rd Ste 3
Newaygo, MI 49337-7982 - Phone
- (231) 923-8092
- NPI assigned
- Mar 10, 2018
- Last updated
- Mar 10, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201009877 | MI | Primary |
Addresses
Primary practice location
1 State Rd Ste 3
Newaygo, MI 49337-7982
Mailing address
2424 Lakewood Rd
Whitehall, MI 49461-9759
Phone (907) 205-9381
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 |
|---|---|---|---|
| 5201009877 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520640000000",
"number": "1053814566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2424 LAKEWOOD RD",
"city": "WHITEHALL",
"state": "MI",
"postal_code": "494619759",
"telephone_number": "907-205-9381"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 STATE RD STE 3",
"city": "NEWAYGO",
"state": "MI",
"postal_code": "493377982",
"telephone_number": "231-923-8092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRYCKI",
"first_name": "AMANDA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-10",
"last_updated": "2018-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201009877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newaygo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.