Active NPI
Marian A Wiegand, CTRS
- Recreation Therapist
- Lenox, MI
National Provider Identifier
1275779472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 52865
- Practice address
- 65936 Haven Ridge Rd
Lenox, MI 48050-1779 - Phone
- (586) 530-6783
- NPI assigned
- Dec 18, 2008
- 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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 52865 | MI | Primary |
Addresses
Primary practice location
65936 Haven Ridge Rd
Lenox, MI 48050-1779
Mailing address
65936 Haven Ridge Rd
Lenox, MI 48050-1779
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52865 | Other | MI | CERTIFIED THERAPEUTIC RECREATION SPECIALIST |
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 |
|---|---|---|---|
| 52865 | MI | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229558400000",
"number": "1275779472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65936 HAVEN RIDGE RD",
"city": "LENOX",
"state": "MI",
"postal_code": "480501779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65936 HAVEN RIDGE RD",
"city": "LENOX",
"state": "MI",
"postal_code": "480501779",
"telephone_number": "586-530-6783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEGAND",
"first_name": "MARIAN",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-12-18",
"last_updated": "2008-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "MI",
"license": "52865",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED THERAPEUTIC RECREATION SPECIALIST",
"identifier": "52865",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lenox, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.