Impact Therapy, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

IMPACT THERAPY, LLC

Practice address

1108 Cadillac Dr SE
Grand Rapids, MI 49506-6514

Phone

(616) 558-4478

NPI assigned

Apr 18, 2022

Last updated

Apr 18, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ashley Rose Brennan, OTR/LNPI 1417458290

Title

Occupational Therapist

Phone

(616) 558-4478

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ashley Rose Brennan, OTR/L

  • Occupational Therapist
  • Grand Rapids, MI
  • NPI 1417458290
  NPD Authorized official

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1619610680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 CADILLAC DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495066514",
            "telephone_number": "616-558-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 CADILLAC DR SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495066514",
            "telephone_number": "616-558-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "BRENNAN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "616-558-4478",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Ana Ilem, PHD
• Francheska Lussien Iliev
• Mergime Imeri, PA
• Immaculate Heart Counseling PLLC
• Immucor Gti Diagnostics, Inc. (Immucor DX)
• Melissa Imperi
• Noor Imran, MD
• In Home Therapy of Grand Rapids, LLC (In Home Therapy of Grand Rapids)
• Inadvance Medicine Associates PA
• Martina Inclan, MD

• Occupational Therapist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.