Individual provider Active NPI

Kaylie Ann Stearns, OTR/L

  • Pediatric Occupational Therapist
  • Grand Haven, MI
National Provider Identifier
1164720405
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
5201008825 Issued in MI
Practice address
533 Woodlawn Ave
Grand Haven, MI 49417-2139
Phone
(616) 402-6997
NPI assigned
Mar 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 5201008825 MI Primary

Addresses

Primary practice location

533 Woodlawn Ave
Grand Haven, MI 49417-2139

Mailing address

533 Woodlawn Ave
Grand Haven, MI 49417-2139
Phone (616) 402-6997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210331000426 MI Practitioner - Occupational Therapist in Private Practice 0941453682 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
5201008825MIMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mi Floortime LLC CurrentSince Sep 29, 2024 Accepting new patients

Locations

17216 Van Wagoner Rd
Spring Lake, MI 49456
Phone (231) 740-7812

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1164720405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 WOODLAWN AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172139",
            "telephone_number": "616-402-6997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 WOODLAWN AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172139",
            "telephone_number": "616-402-6997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEARNS",
        "first_name": "KAYLIE",
        "middle_name": "ANN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-10",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MI",
            "license": "5201008825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.