Scott Dewayne Gothard, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201008224 Issued in MI

Practice address

6376 Quail Run Dr
Kalamazoo, MI 49009-2811

Phone

(269) 544-3764

Fax

(269) 544-3767

NPI assigned

Mar 20, 2012

Sex

Male

Sole proprietor

Yes

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

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• JH Therapy Services

  • Occupational Therapist
  • Lapeer, MI
  • NPI 1104618180
  Medicare reassignment NPD

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1548535792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6376 QUAIL RUN DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092811",
            "telephone_number": "269-544-3764",
            "fax_number": "269-544-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6376 QUAIL RUN DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092811",
            "telephone_number": "269-544-3764",
            "fax_number": "269-544-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTHARD",
        "first_name": "SCOTT",
        "middle_name": "DEWAYNE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201008224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Roland Gorman III, MD
• Jesse Gortner, DO
• Sharon Gorton, L.P.N.
• Christian James Goss, BEHAVIOR TECHNICIAN
• Grace Gostlin, LLBSW
• Jordan Nicole Gottschalk, NP-C
• Kalliopi Goudiotis
• Lindsey Gould, LLMSW
• Tela Gould, RN, BSN
• Claire Gourlay

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.