Individual provider Active NPI

Mary Therese Olbrot, OTRL

  • Occupational Therapist
  • Kalamazoo, MI
National Provider Identifier
1306357561
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201004121 Issued in MI
Practice address
5146 Burning Tree Rd
Kalamazoo, MI 49009-3804
Phone
(269) 615-5297
NPI assigned
Oct 16, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 5201004121 MI Primary

Addresses

Primary practice location

5146 Burning Tree Rd
Kalamazoo, MI 49009-3804

Mailing address

5146 Burning Tree Rd
Kalamazoo, MI 49009-3804
Phone (269) 377-5506

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

LicenseStateTypeSpecialty
5201004121MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508112000000",
    "number": "1306357561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5146 BURNING TREE RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093804",
            "telephone_number": "269-377-5506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5146 BURNING TREE RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490093804",
            "telephone_number": "269-615-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLBROT",
        "first_name": "MARY",
        "middle_name": "THERESE",
        "name_prefix": "Ms.",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2017-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201004121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2017; 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.