Anita Joy Edwards, COTA/L

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Practice address

1059 Wealthy St SE Unit 301
Grand Rapids, MI 49506-1690

Phone

(616) 777-7631

NPI assigned

Jan 12, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1407507353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1059 WEALTHY ST SE UNIT 301",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 WEALTHY ST SE UNIT 301",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495061690",
            "telephone_number": "616-777-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ANITA",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Environmental Modification",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "MI",
            "license": "5202003641",
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED OCCUPATIONAL THERAPY ASSISTANT",
            "identifier": "1009423",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL ACADEMY OF SPORTS MEDICINE",
            "identifier": "1210601573",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY ASSISTANT LICENSE",
            "identifier": "5202003641",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.gigdesign.me",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Client--provider information exchange",
            "address_1": "1059 Wealthy St SE Unit 301",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495061690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carrie A Edmunds
• Edp of Mi, PC
• Michelle Edsall, LLMSW
• Roger W. Edvenson, M.D.
• Edward D Young DDS PC
• Azia Edwards
• Colin Edwards
• Gretchen Edwards
• Jon'Naya C Edwards, BT
• Julie L Edwards, LLP

• Health & Wellness Coach in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Health & Wellness Coach in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.