Active NPI
Brandon Michael Lange
- Mental Health Occupational Therapist
- Allegan, MI
National Provider Identifier
1093310591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Occupational Therapist
- License
- 5202007638
- Practice address
- 677 Ely St
Allegan, MI 49010-1541 - Phone
- (269) 270-7799
- NPI assigned
- Dec 2, 2020
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Occupational Therapist | 225XM0800X | 5202007638 | MI | Primary |
Addresses
Primary practice location
677 Ely St
Allegan, MI 49010-1541
Mailing address
Brandon Lange 3285 122ND Avenue
Allegan, MI 49010
Phone (269) 673-6671
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 |
|---|---|---|---|
| 5202007638 | MI | MD | Mental Health Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1093310591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BRANDON LANGE 3285 122ND AVENUE",
"city": "ALLEGAN",
"state": "MI",
"postal_code": "49010",
"telephone_number": "269-673-6671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "677 ELY ST",
"city": "ALLEGAN",
"state": "MI",
"postal_code": "490101541",
"telephone_number": "269-270-7799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANGE",
"first_name": "BRANDON",
"middle_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-02",
"last_updated": "2020-12-02",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225XM0800X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Mental Health",
"state": "MI",
"license": "5202007638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allegan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.