Active NPI
Brenna Julian Bourdage, OTRL
- Occupational Therapist
- Saginaw, MI
National Provider Identifier
1063052694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201010496
- Practice address
- 515 N Michigan Ave
Saginaw, MI 48602-4316 - Phone
- (989) 583-2817
- NPI assigned
- Jan 11, 2020
- 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 | 5201010496 | MI | Primary |
Addresses
Primary practice location
515 N Michigan Ave
Saginaw, MI 48602-4316
Mailing address
7842 Luann St
Saginaw, MI 48609-4907
Phone (989) 884-2201
Other practice location 1
1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-6510
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | brenna.bourdage@chs-mi.com | ||
| Direct Messaging Address | brenna.bourdage@chs-mi.com |
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 |
|---|---|---|---|
| 5201010496 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578700800000",
"number": "1063052694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7842 LUANN ST",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486094907",
"telephone_number": "989-884-2201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 N MICHIGAN AVE",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486024316",
"telephone_number": "989-583-2817"
}
],
"practiceLocations": [
{
"address_1": "1447 N Harrison St",
"address_purpose": "LOCATION",
"city": "Saginaw",
"state": "MI",
"postal_code": "486024727",
"country_code": "US",
"telephone_number": "989-583-6510",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOURDAGE",
"first_name": "BRENNA",
"middle_name": "JULIAN",
"name_prefix": "Miss",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-11",
"last_updated": "2020-01-11",
"certification_date": "2020-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201010496",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "brenna.bourdage@chs-mi.com",
"affiliation": "N",
"address_1": "515 N Michigan Ave",
"city": "Saginaw",
"state": "MI",
"country_code": "US",
"postal_code": "486024316",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "brenna.bourdage@chs-mi.com",
"affiliation": "N",
"address_1": "1447 N Harrison St",
"city": "Saginaw",
"state": "MI",
"country_code": "US",
"postal_code": "486024727",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Saginaw, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.