Brandi Mack

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1334 Issued in ND

Practice address

1615 E Capitol Way
Bismarck, ND 58501-2218

Phone

(701) 751-0410

NPI assigned

May 13, 2014

Sex

Female

Sole proprietor

Yes

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

Enrolled in ND

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Little Lights Pediatric Therapy, LLC

  • Occupational Therapist
  • Bismarck, ND
  • NPI 1083121792
  Medicare reassignment NPD
• Lake Region Special Education

  • Occupational Therapist
  • Devils Lake, ND
  • NPI 1902904121
  NPD (past)

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1346651361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 E CAPITOL WAY",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585012218",
            "telephone_number": "701-751-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 E CAPITOL WAY",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585012218",
            "telephone_number": "701-751-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "BRANDI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica Retail North America Inc
• Laura Maala
• Molly Macarthur, LAC
• Karen R Macdonald, NP
• Rebecca Marie Macdonald, BSRT (M)(R)(CDT)
• Ashley Macy, APNP
• Jeffrey Thomas Maddock, M.D.
• Jerome P Maddock, CRNA
• Madison L Madler, PT
• Calby A Magilke

• Occupational Therapist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.

Verify at the official NPI Registry.