Active NPI
Randy G Meade, OTR/L, MA,
- Occupational Therapist
- Grand Rapids, MI
National Provider Identifier
1184127631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 401620
- Practice address
- 750 Fuller Ave NE
Grand Rapids, MI 49503-1918 - Phone
- (616) 486-2607
- Fax
- (616) 486-2609
- NPI assigned
- Mar 12, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 401620 | MI | Primary |
Addresses
Primary practice location
750 Fuller Ave NE
Grand Rapids, MI 49503-1918
Mailing address
750 Fuller Ave NE
Grand Rapids, MI 49503-1918
Phone (616) 486-2607
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 401620 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520812800000",
"number": "1184127631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 FULLER AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031918",
"telephone_number": "616-486-2607",
"fax_number": "616-486-2609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 FULLER AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495031918",
"telephone_number": "616-486-2607",
"fax_number": "616-486-2609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEADE",
"first_name": "RANDY",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "OTR/L, MA,",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-12",
"last_updated": "2018-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "401620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.