Michelle Renee Provolt, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

1829 Denver West Dr
Golden, CO 80401-3120

Phone

(303) 982-7276

NPI assigned

Sep 24, 2013

Last updated

Apr 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Children Matter, LLC

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  • NPI 1609109065

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1558797308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8531 W 86TH CIR",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800051517",
            "telephone_number": "847-477-0860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1829 DENVER WEST DR",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804013120",
            "telephone_number": "303-982-7276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVOLT",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-24",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "13-0360",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17185033",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premise Health of Colorado Medical PC (Pete Coors Medical Center)
• Sara Pressley
• Abby L Price
• Pro Athlete Physical Therapy LLC
• Kirk Werner Prochnio, PA-C
• Joseph Pruitt, MD
• Psychotherapy Private Practice
• Nora Lillian Pulford, CRNA
• Cassidy Lawrence Punt
• Jeremy Scott Purney

• Occupational Therapist in Golden, CO
• Providers in Golden, CO by specialty
• Occupational Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.