Brandon Mazzola, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201010163 Issued in MI

Practice address

823 W Michigan Ave
Marshall, MI 49068-1445

Phone

(269) 248-4300

Fax

(269) 781-5505

NPI assigned

Apr 12, 2018

Last updated

Apr 12, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: brandon.mazzola.p4@direct.athleticoltd.nextgenshare.com

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1487151627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6200",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 W MICHIGAN AVE",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490681445",
            "telephone_number": "269-248-4300",
            "fax_number": "269-781-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOLA",
        "first_name": "BRANDON",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201010163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marshall Ophthalmology, PLLC
• Shannon Martin, M.D.
• Carlos H Martinez, MD
• Shirley Ann Martinez, LLP
• Rebecca Sue Matthews, PT, DPT
• Gabrielle McCall, LMSW-C
• Britiany Paige McCarty
• Mercy River Counseling
• Michael A. Meyer, D.O.
• Charles Middleton, DPT

• Occupational Therapist in Marshall, MI
• Providers in Marshall, MI by specialty
• Occupational Therapist in Michigan

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

Verify at the official NPI Registry.