Active NPI
Maddison Dinneweth, CTRS
- Recreation Therapist
- Lake City, MI
National Provider Identifier
1063277283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 85004
- Practice address
- 301 N Main St
Lake City, MI 49651-5102 - Phone
- (231) 295-1196
- NPI assigned
- Feb 16, 2024
- 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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 85004 | MI | Primary |
Addresses
Primary practice location
301 N Main St
Lake City, MI 49651-5102
Mailing address
310 N Front
Lake City, MI 49651-9307
Other names 1
- Maddie Dinneweth
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 |
|---|---|---|---|
| 85004 | MI | MD | Recreation Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grounded Therapy Network LLC | Recreation Therapist | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708041600000",
"number": "1063277283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 N FRONT",
"city": "LAKE CITY",
"state": "MI",
"postal_code": "496519307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 N MAIN ST",
"city": "LAKE CITY",
"state": "MI",
"postal_code": "496515102",
"telephone_number": "231-295-1196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DINNEWETH",
"first_name": "MADDISON",
"credential": "CTRS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-16",
"last_updated": "2024-02-16",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "MI",
"license": "85004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MADDIE",
"last_name": "DINNEWETH",
"credential": "CTRS",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Lake City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.