Active NPI
Ladane Jernell Mosely, MS OTRL
- Occupational Therapist
- Grand Rapids, MI
National Provider Identifier
1366578528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 05398
- Practice address
- 2900 Charlevoix Dr SE
Suite 200
Grand Rapids, MI 49546-7085 - Phone
- (800) 684-8049
- NPI assigned
- Feb 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 05398 | MD | Primary |
Addresses
Primary practice location
2900 Charlevoix Dr SE
Suite 200
Grand Rapids, MI 49546-7085
Mailing address
5505 Highgate Dr
Baltimore, MD 21215-4715
Phone (443) 520-2273
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05398 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366578528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5505 HIGHGATE DR",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212154715",
"telephone_number": "443-520-2273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 CHARLEVOIX DR SE",
"address_2": "SUITE 200",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495467085",
"telephone_number": "800-684-8049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSELY",
"first_name": "LADANE",
"middle_name": "JERNELL",
"name_prefix": "Ms.",
"credential": "MS OTRL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "05398",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.