Organization Active NPI

Nurture Occupational Therapy, PLLC

  • Pediatric Occupational Therapist
  • Novi, MI
National Provider Identifier
1114656501
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
NURTURE OCCUPATIONAL THERAPY, PLLC
Practice address
41850 W 11 Mile Rd Ste 110
Novi, MI 48375-1857
Phone
(616) 308-0719
NPI assigned
Jun 9, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Authorized official

Name
Candace Peterson, MS, OTRL
Title
Occupational Therapist, Owner
Phone
(616) 308-0719

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X
Pediatric Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XP0200X Primary

Addresses

Primary practice location

41850 W 11 Mile Rd Ste 110
Novi, MI 48375-1857

Mailing address

41850 W 11 Mile Rd Ste 110
Novi, MI 48375-1857
Phone (616) 308-0719

Other names 1

  • Lead The Way Therapies Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1114656501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41850 W 11 MILE RD STE 110",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751857",
            "telephone_number": "616-308-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41850 W 11 MILE RD STE 110",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751857",
            "telephone_number": "616-308-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NURTURE OCCUPATIONAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "616-308-0719",
        "authorized_official_credential": "MS, OTRL"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lead The Way Therapies",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lead The Way Therapies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.