Active NPI
Mikell Branch
- Occupational Therapist
- Santa Monica, CA
National Provider Identifier
1447649579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 14487
- Practice address
- 1323 17TH St
Santa Monica, CA 90404-1901 - Phone
- (310) 453-5456
- NPI assigned
- Jan 13, 2015
- Last updated
- Jan 13, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 14487 | CA | Primary |
Addresses
Primary practice location
1323 17TH St
Santa Monica, CA 90404-1901
Mailing address
1323 17TH St
Santa Monica, CA 90404-1901
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421107200000",
"number": "1447649579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1323 17TH ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904041901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1323 17TH ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904041901",
"telephone_number": "310-453-5456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANCH",
"first_name": "MIKELL",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-13",
"last_updated": "2015-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "14487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.