Individual provider Active NPI

Mackenzie Warner

  • Occupational Therapist
  • Kalamazoo, MI
National Provider Identifier
1578076329
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201010346 Issued in MI
Practice address
5659 Stadium Dr Ste 2
Kalamazoo, MI 49009-1932
Phone
(269) 372-0436
NPI assigned
Nov 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Occupational Therapist 225X00000X 5201010346 MI Primary

Addresses

Primary practice location

5659 Stadium Dr Ste 2
Kalamazoo, MI 49009-1932

Mailing address

5659 Stadium Dr Ste 2
Kalamazoo, MI 49009-1932
Phone (269) 372-0436

Other practice location 1

1617 E Milham Ave Ste B
Portage, MI 49002-3049
Phone (269) 389-9102 ext. 108

Other practice location 2

5659 Stadium Dr Ste 2
Kalamazoo, MI 49009-1932
Phone (269) 372-0436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: mackenzie.warner.p4@direct.athleticoltd.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1578076329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5659 STADIUM DR STE 2",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490091932",
            "telephone_number": "269-372-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5659 STADIUM DR STE 2",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490091932",
            "telephone_number": "269-372-0436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1617 E Milham Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Portage",
            "state": "MI",
            "postal_code": "490023049",
            "country_code": "US",
            "telephone_number": "269-389-9102 x108",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5659 Stadium Dr Ste 2",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490091932",
            "country_code": "US",
            "telephone_number": "269-372-0436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARNER",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-14",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201010346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; 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.