Active NPI
Nichole Roost, OTR/L
- Hand Occupational Therapist
- Traverse City, MI
National Provider Identifier
1548656366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hand Occupational Therapist
- License
- 5201011112
- Practice address
- 4110 Copper Ridge Dr Ste 204D
Traverse City, MI 49684-6721 - Phone
- (231) 300-8411
- NPI assigned
- Apr 8, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hand Occupational Therapist | 225XH1200X | 5201011112 | MI | Primary |
Addresses
Primary practice location
4110 Copper Ridge Dr Ste 204D
Traverse City, MI 49684-6721
Mailing address
4110 Copper Ridge Dr Ste 204D
Traverse City, MI 49684-6721
Phone (231) 300-8411
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15181 | CA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bayshore Hand Rehabilitation | Hand | Current | Accepting new patients |
| Hand Surgery of Northern Michigan PLC | Hand | Current | Accepting new patients |
| Hand Surgery of Northern Michigan PLC | Current | Accepting new patients |
Locations
701 W Front St
Ste 100
Traverse City, MI 49684
Phone (231) 935-0800
4110 Copper Ridge Dr
Ste 204D
Traverse City, MI 49684
Phone (231) 300-8411
Organizations & group practices 3
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.
-
- Orthopaedic Hand Surgery Physician
- Traverse City, MI
- NPI 1497778765
-
- Durable Medical Equipment & Medical Supplies
- Traverse City, MI
- NPI 1356487870
Hand
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713744000000",
"number": "1548656366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4110 COPPER RIDGE DR STE 204D",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496846721",
"telephone_number": "231-300-8411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4110 COPPER RIDGE DR STE 204D",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496846721",
"telephone_number": "231-300-8411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOST",
"first_name": "NICHOLE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-08",
"last_updated": "2024-04-22",
"certification_date": "2024-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "MI",
"license": "5201011112",
"primary": true
}
],
"identifiers": [],
"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 Apr 22, 2024; 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.