Active NPI
Brandon Michael Hoenicke, CTRS
- Recreation Therapist
- Sterling Heights, MI
National Provider Identifier
1235640939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 65749
- Practice address
- 35514 Indigo Dr
Sterling Heights, MI 48310-4946 - Phone
- (586) 212-2671
- NPI assigned
- Oct 20, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 65749 | MI | Primary |
Addresses
Primary practice location
35514 Indigo Dr
Sterling Heights, MI 48310-4946
Mailing address
128 Church St
Romeo, MI 48065-4605
Phone (586) 243-3132
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 65749 | MI | MD | Recreation Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic Concepts, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Sterling Heights, MI
- NPI 1497989263
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508457600000",
"number": "1235640939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 CHURCH ST",
"city": "ROMEO",
"state": "MI",
"postal_code": "480654605",
"telephone_number": "586-243-3132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35514 INDIGO DR",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483104946",
"telephone_number": "586-212-2671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOENICKE",
"first_name": "BRANDON",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-20",
"last_updated": "2017-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "MI",
"license": "65749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.