Individual provider Active NPI

Sara Kroll, OT

  • Occupational Therapist
  • Marquette, MI
National Provider Identifier
1396804126
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201006675 Issued in MI
Practice address
580 W College Ave
Marquette, MI 49855-2736
Phone
(906) 225-4849
Fax
(906) 225-5572
NPI assigned
Dec 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1971 AK
Occupational Therapist 225X00000X 5201006675 MI Primary

Addresses

Primary practice location

580 W College Ave
Marquette, MI 49855-2736

Mailing address

555 County Road HQ
Marquette, MI 49855-8855
Phone (906) 225-5570

Other identifiers 1

IdentifierTypeStateIssuer
1791OtherAKOT LICENCE #

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

State licenses

LicenseStateTypeSpecialty
1791AKMDPharmacist
1971AKMDPharmacist
5201006675MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1396804126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 COUNTY ROAD HQ",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498558855",
            "telephone_number": "906-225-5570",
            "fax_number": "906-225-5572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W COLLEGE AVE",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498552736",
            "telephone_number": "906-225-4849",
            "fax_number": "906-225-5572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLL",
        "first_name": "SARA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-07",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "1971",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201006675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT LICENCE #",
            "identifier": "1791",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.