Individual provider Active NPI

Megan Aubrey Sellenraad, OTR/L

  • Occupational Therapist
  • Traverse City, MI
National Provider Identifier
1417064148
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201007598 Issued in MI
Practice address
808 S Garfield Ave
Suite a
Traverse City, MI 49686-3464
Phone
(231) 929-2354
Fax
(231) 929-2853
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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 056-007436 IL
Occupational Therapist 225X00000X 5201007598 MI Primary

Addresses

Primary practice location

808 S Garfield Ave
Suite a
Traverse City, MI 49686-3464

Mailing address

8080 N Swede Rd
Northport, MI 49670-9401
Phone (231) 386-7298

Other identifiers 1

IdentifierTypeStateIssuer
A2741KD1MedicaidIL

Other names 1

  • Mrs. Megan Aubrey Sellenraad-Hamelin Other name

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
056-007436ILMDOccupational Therapist
5201007598MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Making Strides LLC Occupational Therapist Current Accepting new patients
Easter Seals Dupage and the Fox Valley Region Occupational Therapist Past Accepting new patients
Easter Seals Dupage and the Fox Valley Region Occupational Therapist PastSince Mar 14, 2017 Accepting new patients

Organizations & group practices 3

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1417064148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 N SWEDE RD",
            "city": "NORTHPORT",
            "state": "MI",
            "postal_code": "496709401",
            "telephone_number": "231-386-7298",
            "fax_number": "231-929-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S GARFIELD AVE",
            "address_2": "SUITE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863464",
            "telephone_number": "231-929-2354",
            "fax_number": "231-929-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLENRAAD",
        "first_name": "MEGAN",
        "middle_name": "AUBREY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056-007436",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201007598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A2741KD1",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "SELLENRAAD-HAMELIN",
            "middle_name": "AUBREY",
            "prefix": "MRS.",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.