Active NPI
Great Lakes Hand Therapy PC
- Hand Occupational Therapist
- Battle Creek, MI
National Provider Identifier
1568628790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hand Occupational Therapist
- License
- 5201002623
- Legal business name
- GREAT LAKES HAND THERAPY PC
- Practice address
- 3600 Capital Ave SW Ste 103
Battle Creek, MI 49015 - Phone
- (269) 979-0874
- Fax
- (269) 979-0901
- NPI assigned
- Aug 7, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa Marie Willems
- Title
- Billing
- Phone
- (269) 372-7200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hand Occupational Therapist | 225XH1200X | 5201002623 | MI | Primary |
Addresses
Primary practice location
3600 Capital Ave SW Ste 103
Battle Creek, MI 49015
Mailing address
3600 Capital Ave SW Ste 103
Battle Creek, MI 49015-9393
Phone (269) 979-0874
Other names 1
- HAND THERAPY OF MICHIGAN
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930003669 | MI | DME Supplier - Independently-Practicing Occupational Therapist | 0840109930 | Practice locations: Battle Creek, MI |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Great Lakes Hand Therapy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Occupational Therapist
- Portage, MI
- NPI 1437378932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218067200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698105600000",
"number": "1568628790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 CAPITAL AVE SW STE 103",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "490159393",
"telephone_number": "269-979-0874",
"fax_number": "269-979-0901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 CAPITAL AVE SW STE 103",
"city": "BATTLE CREEK",
"state": "MI",
"postal_code": "49015",
"telephone_number": "269-979-0874",
"fax_number": "269-979-0901"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREAT LAKES HAND THERAPY PC",
"organizational_subpart": "NO",
"enumeration_date": "2008-08-07",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A",
"authorized_official_last_name": "WILLEMS",
"authorized_official_first_name": "LISA",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "BILLING",
"authorized_official_telephone_number": "269-372-7200"
},
"taxonomies": [
{
"code": "225XH1200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist, Hand",
"state": "MI",
"license": "5201002623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "HAND THERAPY OF MICHIGAN",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "HAND THERAPY OF MICHIGAN",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Battle Creek, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.