Kaitlyn Grace Malburg, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201009671 Issued in MI

Practice address

9100 Lapeer Rd
Davison, MI 48423-3620

Phone

(810) 653-0100

Fax

(810) 653-0133

NPI assigned

Aug 24, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503532800000",
    "number": "1679090328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 CHURCH RD",
            "city": "CASCO",
            "state": "MI",
            "postal_code": "480641805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 LAPEER RD",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484233620",
            "telephone_number": "810-653-0100",
            "fax_number": "810-653-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALBURG",
        "first_name": "KAITLYN",
        "middle_name": "GRACE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2017-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; 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.