Active NPI
Melissa Jean Van Omen, MSOT
- Occupational Therapist
- New Buffalo, MI
National Provider Identifier
1083493894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201011333
- Practice address
- 45 N Whittaker St Ste 204
New Buffalo, MI 49117-1173 - Phone
- (269) 235-9821
- Fax
- (269) 359-3735
- NPI assigned
- Sep 22, 2023
- Last updated
- Sep 22, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056.014673 | IL | |
| Occupational Therapist | 225X00000X | 5201011333 | MI | Primary |
Addresses
Primary practice location
45 N Whittaker St Ste 204
New Buffalo, MI 49117-1173
Mailing address
9676 Bingham St
Zeeland, MI 49464-9464
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056.014673 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695340800000",
"number": "1083493894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9676 BINGHAM ST",
"city": "ZEELAND",
"state": "MI",
"postal_code": "494649464",
"fax_number": "269-359-3735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 N WHITTAKER ST STE 204",
"city": "NEW BUFFALO",
"state": "MI",
"postal_code": "491171173",
"telephone_number": "269-235-9821",
"fax_number": "269-359-3735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN OMEN",
"first_name": "MELISSA",
"middle_name": "JEAN",
"credential": "MSOT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-22",
"last_updated": "2023-09-22",
"certification_date": "2023-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056.014673",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201011333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Buffalo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.