Active NPI
McKenzie Mortensen, MS OTR/L
- Occupational Therapist
- Ann Arbor, MI
National Provider Identifier
1336508159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201012978
- Practice address
- 1540 E Hospital Dr
Ann Arbor, MI 48109-4000 - Phone
- (734) 936-4000
- NPI assigned
- Feb 22, 2016
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 11840 | NC | |
| Occupational Therapist | 225X00000X | 5201012978 | MI | Primary |
| Occupational Therapist | 225X00000X | 6475 | AZ |
Addresses
Primary practice location
1540 E Hospital Dr
Ann Arbor, MI 48109-4000
Mailing address
635 S Maple Rd Ste 2
Ann Arbor, MI 48103-3838
Phone (734) 369-6002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220919000830 | MI | Practitioner - Occupational Therapist in Private Practice | 7810372414 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6475 | AZ | MD | Occupational Therapist |
| 11840 | NC | MD | Occupational Therapist |
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": "1456099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763683200000",
"number": "1336508159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "635 S MAPLE RD STE 2",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481033838",
"telephone_number": "734-369-6002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 E HOSPITAL DR",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481094000",
"telephone_number": "734-936-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORTENSEN",
"first_name": "MCKENZIE",
"credential": "MS OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-22",
"last_updated": "2025-11-21",
"certification_date": "2025-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "11840",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201012978",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "6475",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.