Active NPI
Gretchen Gaylord Fraser, OTR, CLT-LANA
- Occupational Therapist
- Traverse City, MI
National Provider Identifier
1497259642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201003389
- Practice address
- 2970 Keewaydin TRL
Traverse City, MI 49686-8564 - Phone
- (231) 392-1756
- NPI assigned
- Mar 22, 2018
- Sex
- Female
- 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 | 5201003389 | MI | Primary |
Addresses
Primary practice location
2970 Keewaydin TRL
Traverse City, MI 49686-8564
Mailing address
2970 Keewaydin TRL
Traverse City, MI 49686-8564
Phone (231) 392-1756
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326124322 | Medicaid | MI |
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 |
|---|---|---|---|
| 5201003389 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521676800000",
"number": "1497259642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2970 KEEWAYDIN TRL",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496868564",
"telephone_number": "231-392-1756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2970 KEEWAYDIN TRL",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496868564",
"telephone_number": "231-392-1756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRASER",
"first_name": "GRETCHEN",
"middle_name": "GAYLORD",
"credential": "OTR, CLT-LANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-22",
"last_updated": "2018-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201003389",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1326124322",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}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 Mar 22, 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.