Active NPI
Miranda Mackew, COTAL
- Occupational Therapy Assistant
- Clinton TWP, MI
National Provider Identifier
1275099111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5202008434
- Practice address
- 43478 Meadowlark Cir
Clinton TWP, MI 48036-3352 - Phone
- (586) 840-6053
- NPI assigned
- Feb 15, 2019
- Last updated
- Feb 15, 2019
- 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 Therapy Assistant | 224Z00000X | 5202008434 | MI | Primary |
Addresses
Primary practice location
43478 Meadowlark Cir
Clinton TWP, MI 48036-3352
Mailing address
43478 Meadowlark Cir
Clinton TWP, MI 48036-3352
Phone (586) 840-6053
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 |
|---|---|---|---|
| 5202008434 | MI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550188800000",
"number": "1275099111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43478 MEADOWLARK CIR",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480363352",
"telephone_number": "586-840-6053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43478 MEADOWLARK CIR",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480363352",
"telephone_number": "586-840-6053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKEW",
"first_name": "MIRANDA",
"credential": "COTAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-15",
"last_updated": "2019-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MI",
"license": "5202008434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton TWP, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.