Brian Matthew Oconnell, PT, OCS, CERT MDT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

5501013083 Issued in MI

Practice address

4100 Lake Dr SE Ste B03
Grand Rapids, MI 49546-8292

Phone

(616) 267-8365

NPI assigned

Mar 9, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Kathleen J. Grace RPT Apc

  • Surgical Physician Assistant
  • San Diego, CA
  • NPI 1740201730
  NPD (past)

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1306349006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE STE B03",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 LAKE DR SE STE B03",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468292",
            "telephone_number": "616-267-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCONNELL",
        "first_name": "BRIAN",
        "middle_name": "MATTHEW",
        "credential": "PT, OCS, CERT MDT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-09",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "5501013083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Yasmine Occes Francois
• Occupational Health Centers of Michigan, P.C. (Concentra Medical Center)
• Occupational Health Centers of Michigan, P.C. (Concentra Medical Center)
• Juan Ochoa
• Robert Conrad Ocomen
• Ashley Nicole Oconnor, RRT
• John R Oconnor, PT
• Richard Phillip Oconnor Jr., MD
• Oculoplastic Associates of West Michigan, PLC
• Coby K Odate

• Orthopedic Physical Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Orthopedic Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.