Individual provider Active NPI

Joanne Ryan

  • Occupational Therapist
  • Grand Rapids, MI
National Provider Identifier
1679902233
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201000094 Issued in MI
Practice address
560 5TH St NW
NW Suite 404
Grand Rapids, MI 49504-5219
Phone
(616) 356-5000
NPI assigned
Nov 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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 5201000094 MI Primary

Addresses

Primary practice location

560 5TH St NW
NW Suite 404
Grand Rapids, MI 49504-5219

Mailing address

18291 Aspen TRL
Brownstown, MI 48174-9258
Phone (734) 955-6598

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5201000094MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stanton Crossings Physical Therapy LLC Past Accepting new patients

Organizations & group practices 1

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": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1679902233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18291 ASPEN TRL",
            "city": "BROWNSTOWN",
            "state": "MI",
            "postal_code": "481749258",
            "telephone_number": "734-955-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 5TH ST NW",
            "address_2": "NW SUITE 404",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045219",
            "telephone_number": "616-356-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "JOANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201000094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.