Active NPI
Madeline Irene Maloley
- Recreation Therapist
- Grand Rapids, MI
National Provider Identifier
1336683390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 69793
- Practice address
- 606 Clinton Ave NW
Grand Rapids, MI 49534-3518 - Phone
- (616) 914-4037
- NPI assigned
- Dec 10, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 69793 | MI | Primary |
Addresses
Primary practice location
606 Clinton Ave NW
Grand Rapids, MI 49534-3518
Mailing address
606 Clinton Ave NW
Grand Rapids, MI 49534-3518
Phone (616) 914-4037
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 |
|---|---|---|---|
| 69793 | MI | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1336683390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "606 CLINTON AVE NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495343518",
"telephone_number": "616-914-4037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "606 CLINTON AVE NW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495343518",
"telephone_number": "616-914-4037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALOLEY",
"first_name": "MADELINE",
"middle_name": "IRENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-10",
"last_updated": "2022-09-12",
"certification_date": "2022-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "MI",
"license": "69793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.