Individual provider Active NPI

Brad Jezewski

  • Occupational Therapist
  • Marquette, MI
National Provider Identifier
1689178840
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
555 County Road HQ
Marquette, MI 49855-8855
Phone
(906) 225-5044
NPI assigned
Mar 22, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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 Primary

Addresses

Primary practice location

555 County Road HQ
Marquette, MI 49855-8855

Mailing address

555 County Road HQ
Marquette, MI 49855-8855

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

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1689178840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 COUNTY ROAD HQ",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498558855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 COUNTY ROAD HQ",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498558855",
            "telephone_number": "906-225-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEZEWSKI",
        "first_name": "BRAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.