Active NPI
Carrie Stephens, CTRS
- Recreation Therapist
- Wyoming, MI
National Provider Identifier
1063802809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 52286
- Practice address
- 3353 Lousma Dr SE
Wyoming, MI 49548-2251 - Phone
- (616) 241-6258
- NPI assigned
- Feb 2, 2015
- 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 | 52286 | Primary |
Addresses
Primary practice location
3353 Lousma Dr SE
Wyoming, MI 49548-2251
Mailing address
3353 Lousma Dr SE
Wyoming, MI 49548-2251
Phone (616) 241-6258
Other names 1
- Carrie Haydene
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423094400000",
"number": "1063802809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3353 LOUSMA DR SE",
"city": "WYOMING",
"state": "MI",
"postal_code": "495482251",
"telephone_number": "616-241-6258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3353 LOUSMA DR SE",
"city": "WYOMING",
"state": "MI",
"postal_code": "495482251",
"telephone_number": "616-241-6258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "CARRIE",
"credential": "CTRS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-02",
"last_updated": "2015-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": null,
"license": "52286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CARRIE",
"last_name": "HAYDENE",
"credential": "CTRS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.