Active NPI
Reanna L Dawson, COTA/L
- Occupational Therapy Assistant
- Grand Rapids, MI
National Provider Identifier
1477028827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5202006826
- Practice address
- 3600 Fulton St E
Grand Rapids, MI 49546-1322 - Phone
- (616) 949-4971
- NPI assigned
- Oct 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Rehabilitation Occupational Therapist | 225XP0019X | 5202006826 | MI | |
| Occupational Therapy Assistant | 224Z00000X | 5202006826 | MI | Primary |
Addresses
Primary practice location
3600 Fulton St E
Grand Rapids, MI 49546-1322
Mailing address
2562 Linda Ave SE
Grand Rapids, MI 49546-6780
Phone (616) 914-7998
Other practice location 1
111 Lakeside Dr NE
Grand Rapids, MI 49503-3811
Phone (616) 588-1645
Other practice location 2
1551 Franklin St SE
Grand Rapids, MI 49506-8203
Phone (616) 452-1568
Other practice location 3
948 Washington Ave
Holland, MI 49423-5205
Phone (616) 796-3500
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5202006826 | MI | MD | Physical Rehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539216000000",
"number": "1477028827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2562 LINDA AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495466780",
"telephone_number": "616-914-7998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 FULTON ST E",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495461322",
"telephone_number": "616-949-4971"
}
],
"practiceLocations": [
{
"address_1": "111 Lakeside Dr NE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495033811",
"country_code": "US",
"telephone_number": "616-588-1645",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1551 Franklin St SE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495068203",
"country_code": "US",
"telephone_number": "616-452-1568",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "948 Washington Ave",
"address_purpose": "LOCATION",
"city": "Holland",
"state": "MI",
"postal_code": "494235205",
"country_code": "US",
"telephone_number": "616-796-3500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAWSON",
"first_name": "REANNA",
"middle_name": "L",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-11",
"last_updated": "2018-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0019X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Physical Rehabilitation",
"state": "MI",
"license": "5202006826",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MI",
"license": "5202006826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.