Individual provider Active NPI

Mark Schmidtke, OTR

  • Occupational Therapist
  • Grand Rapids, MI
National Provider Identifier
1366618571
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201003841 Issued in MI
Practice address
1111 Leffingwell Ave NE
Suite 200
Grand Rapids, MI 49525-6406
Phone
(616) 459-7101
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201003841 MI Primary

Addresses

Primary practice location

1111 Leffingwell Ave NE
Suite 200
Grand Rapids, MI 49525-6406

Mailing address

PO Box 30516
Dept 6063
Lansing, MI 48909-8016
Phone (616) 459-7101

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Hand Center, PLC Occupational Therapist Past Accepting new patients
Orthopaedic Associates of Grand Rapids, PC Past Accepting new patients

Organizations & group practices 2

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": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378944000000",
    "number": "1366618571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "address_2": "DEPT 6063",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489098016",
            "telephone_number": "616-459-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 LEFFINGWELL AVE NE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256406",
            "telephone_number": "616-459-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDTKE",
        "first_name": "MARK",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2013-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201003841",
            "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, 2013; 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.