Reegan Elles Edema, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201013945 Issued in MI

Practice address

2855 44TH St SW Ste 160
Grandville, MI 49418-2682

Phone

(616) 379-9887

Fax

(616) 253-6061

NPI assigned

Sep 10, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Thrive Pediatric Speech and Feeding Therapy, LLC

  • Multi-Specialty Clinic/Center
  • Grandville, MI
  • NPI 1265074827
  Medicare reassignment

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1184450868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 44TH ST SW STE 160",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182682",
            "telephone_number": "616-379-9887",
            "fax_number": "616-253-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 44TH ST SW STE 160",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182682",
            "telephone_number": "616-379-9887",
            "fax_number": "616-253-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEMA",
        "first_name": "REEGAN",
        "middle_name": "ELLES",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201013945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abraham Eapen
• Sherah Janette Eavey, OD
• Calvin Daniel Ebels, O.D.
• Theresa Eddie, MA, CCC-SLP
• Emory Stewart Eddy, LLPC
• Evonne M Edwards, LLP
• Skylar Brielle Edwards I
• Robert L Eggleston, DDS
• Amol Shantaram Ekhande, M.D.
• Andrea Rose Elder

• Occupational Therapist in Grandville, MI
• Providers in Grandville, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.