Laura B Hagan, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201004245 Issued in MI

Practice address

10020 Professional Center Dr.
Suite 100
Hamburg, MI 48139

Phone

(810) 231-6904

NPI assigned

Nov 2, 2006

Last updated

May 8, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Laura Bricker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431043200000",
    "number": "1649358953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10020 PROFESSIONAL CENTER DR.",
            "address_2": "SUITE 100",
            "city": "HAMBURG",
            "state": "MI",
            "postal_code": "48139",
            "telephone_number": "810-231-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "LAURA",
        "middle_name": "B",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2015-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "2485",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201004245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2485",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01437456",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "BRICKER",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maria Da Cruz
• Victoria Lee Dawson, LMSW
• Cynthia Catherine Dematteis, ATC
• Rodney L Dewyer, MD
• Catherine Ann Ebbert, OTR/L
• Danelle Hale, DPT
• Elizabeth Anne Howell, PT
• Iha Health Services Corporation (IHA Hamburg Primary Care)
• Alyssa Kelsey, PT
• Kensington Valley Orthotic & Sports Services

• Occupational Therapist in Hamburg, MI
• Providers in Hamburg, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.