Active NPI
Tessa Hagen
- Occupational Therapist
- Norton Shores, MI
National Provider Identifier
1245720283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201010181
- Practice address
- 945 E Sherman Blvd
Norton Shores, MI 49444-1805 - Phone
- (231) 737-4374
- NPI assigned
- May 15, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201010181 | MI | Primary |
Addresses
Primary practice location
945 E Sherman Blvd
Norton Shores, MI 49444-1805
Mailing address
945 E Sherman Blvd
Norton Shores, MI 49444-1805
Phone (231) 737-4374
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230616000963 | MI | Practitioner - Occupational Therapist in Private Practice | 8729446133 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5201010181 | MI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Speech and Voice Solutions LLC | Current | Accepting new patients |
Locations
627 Elliott Ave
Grand Haven, MI 49417
Phone (231) 327-4252
2251 East Paris Ave SE
Grand Rapids, MI 49546
Phone (616) 447-7799
570 E Division St
Rockford, MI 49341
Phone (616) 447-7799
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.
-
- Speech-Language Pathologist
- Grand Rapids, MI
- NPI 1336419696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526342400000",
"number": "1245720283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "945 E SHERMAN BLVD",
"city": "NORTON SHORES",
"state": "MI",
"postal_code": "494441805",
"telephone_number": "231-737-4374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 E SHERMAN BLVD",
"city": "NORTON SHORES",
"state": "MI",
"postal_code": "494441805",
"telephone_number": "231-737-4374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAGEN",
"first_name": "TESSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-15",
"last_updated": "2018-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201010181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norton Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.