Individual provider Active NPI

Julie Jordan Cook, OTRL

  • Neurorehabilitation Occupational Therapist
  • Traverse City, MI
National Provider Identifier
1255769188
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurorehabilitation Occupational TherapistTaxonomy code 225XN1300X
License
5201000051 Issued in MI
Practice address
808 S Garfield Ave Ste a
Traverse City, MI 49686-3464
Phone
(231) 929-2354
NPI assigned
Nov 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201000051 MI
Neurorehabilitation Occupational Therapist 225XN1300X 5201000051 MI Primary

Addresses

Primary practice location

808 S Garfield Ave Ste a
Traverse City, MI 49686-3464

Mailing address

PO Box 674779
Detroit, MI 48267-4779

Other identifiers 1

IdentifierTypeStateIssuer
1255769188MedicaidMI

Other names 1

  • Julie Lynn Jordan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160314002153 MI Practitioner - Occupational Therapist in Private Practice 5294031449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Beyond Barriers RehabilitationGroup PAC ID 4880829738, 16 clinicians

Practice addresses (Care Compare)

415 Munson Ave
Traverse City, MI 49686-3059
Phone (231) 486-6330

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201000051MIMDNeurorehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Life Beyond Barriers Rehabilitation CurrentSince Jan 20, 2016 Accepting new patients

Locations

415 Munson Ave
Ste 101
Traverse City, MI 49686
Phone (231) 486-6330

415 Munson Ave
Ste 103
Traverse City, MI 49686
Phone (231) 486-6330

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.

NPI Registry JSON

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1255769188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 674779",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482674779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S GARFIELD AVE STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863464",
            "telephone_number": "231-929-2354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "JULIE",
        "middle_name": "JORDAN",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-01",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201000051",
            "primary": false
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "MI",
            "license": "5201000051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255769188",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "JORDAN",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.