Kristie J Brogan, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201008853 Issued in MI

Practice address

1200 Earhart Rd
Ann Arbor, MI 48105-2768

Phone

(734) 769-6410

NPI assigned

Aug 6, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• 3 Dimensional Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Adrian, MI
  • NPI 1164676730
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533513600000",
    "number": "1083192512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 WATERS RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039289",
            "telephone_number": "734-915-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EARHART RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052768",
            "telephone_number": "734-769-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGAN",
        "first_name": "KRISTIE",
        "middle_name": "J",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2018-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201008853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ian Brodka, MD
• David Brodnik, MD
• Jonathan Broek
• Nicholas Broeker, BCBA,LBA
• Eric Thomas Broekhuizen, ATC
• Kristen Brogdon, PT, DPT
• Heidi Marie Brogger, CRNA
• Steven Broglio, ATC, PHD
• Paulette Bromberg, PH.D.
• Katherine Bromm, PHARMD

• Occupational Therapist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.