Audra Lou Kuperus, COTAL

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5202008414 Issued in MI

Practice address

3600 Fulton St E
Grand Rapids, MI 49546-1322

Phone

(616) 949-4971

NPI assigned

Oct 12, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1225503501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6351 N BROADWAY RD",
            "city": "FREEPORT",
            "state": "MI",
            "postal_code": "493259712",
            "telephone_number": "616-212-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 FULTON ST E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495461322",
            "telephone_number": "616-949-4971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPERUS",
        "first_name": "AUDRA",
        "middle_name": "LOU",
        "credential": "COTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-12",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MI",
            "license": "5202008414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Kunnen
• Randall Scott Kuntzman, M.D.
• Kimberley A Kunze, PSY.D.
• Michael Kuo, MD
• Sherry Kuo, DO
• Joshua Mark Kuperus
• Jayme Lee Kuras
• Mary Gallager Kuras, CCC-SLP
• Patrick Michael Kurecka, M.D.
• Rachel Kurecka, PA-C

• Occupational Therapy Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Occupational Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.