Individual provider Active NPI

Marcia Ritzert Barrett, OTR, CLT

  • Occupational Therapist
  • South Bend, IN
National Provider Identifier
1376020701
Registry record updated Jul 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201006932 Issued in MI
Practice address
111 W Jefferson Blvd Ste 100
South Bend, IN 46601-1993
Phone
(574) 315-2056
NPI assigned
Jul 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2018

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 5201006932 MI Primary

Addresses

Primary practice location

111 W Jefferson Blvd Ste 100
South Bend, IN 46601-1993

Mailing address

30980 Chadwick Dr
Granger, IN 46530-4332
Phone (574) 315-2056

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

LicenseStateTypeSpecialty
5201006932MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532649600000",
    "number": "1376020701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30980 CHADWICK DR",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465304332",
            "telephone_number": "574-315-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W JEFFERSON BLVD STE 100",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011993",
            "telephone_number": "574-315-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETT",
        "first_name": "MARCIA",
        "middle_name": "RITZERT",
        "credential": "OTR, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-27",
        "last_updated": "2018-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201006932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2018; 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.