NPIMap

Organization Active NPI

Great Lakes Hand Therapy PC

  • Occupational Therapist
  • Portage, MI
National Provider Identifier
1437378932
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
GREAT LAKES HAND THERAPY PC
Doing business as
Hand Therapy of Michigan
Practice address
7971 Moorsbridge Rd
Portage, MI 49024-4075
Phone
(269) 321-0929
Fax
(269) 321-1767
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Authorized official

Name
Lisa Marie Willems
Title
Manager
Phone
(269) 372-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

7971 Moorsbridge Rd
Portage, MI 49024-4075

Mailing address

7901 S 12TH St
Suite #200
Portage, MI 49024-3831
Phone (269) 372-7200

Other names 1

  • Hand Therapy of Michigan Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071023000222 MI Part B Supplier - Clinic/Group Practice 0840109930 Receives reassigned benefits from 5 practitioners
Practice locations: Battle Creek, MI
O20100930003668 MI DME Supplier - Independently-Practicing Occupational Therapist 0840109930 Practice locations: Portage, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Great Lakes Hand Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3600 Capital Ave SW
Ste 103
Battle Creek, MI 49015
Phone (269) 979-0874

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1437378932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 S 12TH ST",
            "address_2": "SUITE #200",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490243831",
            "telephone_number": "269-372-7200",
            "fax_number": "269-372-1630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7971 MOORSBRIDGE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244075",
            "telephone_number": "269-321-0929",
            "fax_number": "269-321-1767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES HAND THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "WILLEMS",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "269-372-7200"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hand Therapy of Michigan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.