Individual provider Active NPI

Jordan Brandi Mulders, OTRL, CBIS

  • Occupational Therapist
  • Ann Arbor, MI
National Provider Identifier
1568958049
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201010266 Issued in MI
Practice address
5060 Jackson Rd Ste D
Ann Arbor, MI 48103-1867
Phone
(734) 627-8001
Fax
(734) 433-1989
NPI assigned
Jul 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201010266 MI Primary

Addresses

Primary practice location

5060 Jackson Rd Ste D
Ann Arbor, MI 48103-1867

Mailing address

3539 21St St
Wyandotte, MI 48192-6303
Phone (989) 239-1340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250501000145 MI Practitioner - Occupational Therapist in Private Practice 8325564446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Wayne State University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5060 Jackson Rd
Suite D
Ann Arbor, MI 48103-1867
Phone (734) 627-8001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life Skills Community Rehabilitation & Associates LLC CurrentSince Apr 21, 2025 Accepting new patients
Life Skills Community Rehabilitation & Associates LLC Occupational Therapist CurrentSince Apr 21, 2025 Accepting new patients

Locations

5060 Jackson Rd
Ste D
Ann Arbor, MI 48103
Phone (734) 627-8001

Interoperability endpoints

  • Direct secure messaging: jmulders778080@direct.hfhs.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1531008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1568958049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3539 21ST ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481926303",
            "telephone_number": "989-239-1340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 JACKSON RD STE D",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481031867",
            "telephone_number": "734-627-8001",
            "fax_number": "734-433-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDERS",
        "first_name": "JORDAN",
        "middle_name": "BRANDI",
        "credential": "OTRL, CBIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-08",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201010266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.