Active NPI
Gretchen Alene Decarteret, CTRS
- Recreation Therapist
- Brighton, MI
National Provider Identifier
1093390262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 23642
- Practice address
- 7200 Challis Rd
Brighton, MI 48116-7411 - Phone
- (810) 227-0119
- NPI assigned
- Mar 10, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 23642 | MI | Primary |
Addresses
Primary practice location
7200 Challis Rd
Brighton, MI 48116-7411
Mailing address
8440 O'Connell Rd
Fenton, MI 48430
Phone (517) 404-0863
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 |
|---|---|---|---|
| 23642 | MI | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1093390262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8440 O'CONNELL RD",
"city": "FENTON",
"state": "MI",
"postal_code": "48430",
"telephone_number": "517-404-0863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7200 CHALLIS RD",
"city": "BRIGHTON",
"state": "MI",
"postal_code": "481167411",
"telephone_number": "810-227-0119"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECARTERET",
"first_name": "GRETCHEN",
"middle_name": "ALENE",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-10",
"last_updated": "2021-03-10",
"certification_date": "2021-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "MI",
"license": "23642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.