Andrea Bouwknegt
Individual provider Active NPI Occupational Therapy Assistant · Big Rapids, MI
NPI 1144019134 · NPPES record last updated May 5, 2025
Key facts
- NPI
- 1144019134
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 24291041001 (MI)
- Practice address
- 725 Fuller Ave
Big Rapids, MI 49307-2105 - Phone
- (231) 796-2631
- NPI assigned
- May 5, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24291041001 | MI | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 24291041001 | MI | Yes |
Addresses
Primary practice location
725 Fuller Ave
Big Rapids, MI 49307-2105
Mailing address
9097 S Thornapple Ave
Newaygo, MI 49337-8656
Phone (231) 414-4391
NPI Registry JSON
{
"created_epoch": "1746403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746403200000",
"number": "1144019134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9097 S THORNAPPLE AVE",
"city": "NEWAYGO",
"state": "MI",
"postal_code": "493378656",
"telephone_number": "231-414-4391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 FULLER AVE",
"city": "BIG RAPIDS",
"state": "MI",
"postal_code": "493072105",
"telephone_number": "231-796-2631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUWKNEGT",
"first_name": "ANDREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-05",
"last_updated": "2025-05-05",
"certification_date": "2025-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MI",
"license": "24291041001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Big Rapids, MI
- Rudy R. D. Bogoian III
- Emily Joy Bongard
- Julie A Boss
- Christy Bourdlais
- Amanda Grace Bouvrette
- Dawn Boven
- Brooklynn Boyd
- Matthew D Bradley
- Kristi Kae Brege
- Kara Nicole Bremer
All providers in Big Rapids, MI · Occupational Therapy Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.