Individual provider Active NPI

Dawn Veronica Holland, OTR/L

  • Occupational Therapist
  • Jackson, MI
National Provider Identifier
1689246605
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201003801 Issued in MI
Practice address
1001 Laurence Ave
Jackson, MI 49202-2979
Phone
(517) 750-4777
Fax
(517) 782-4717
NPI assigned
Jul 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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 5201003801 MI Primary

Addresses

Primary practice location

1001 Laurence Ave
Jackson, MI 49202-2979

Mailing address

1001 Laurence Ave
Jackson, MI 49202-2979
Phone (517) 750-4777

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dawn@therapyjackson.com Direct Comprehensive Speech and Therapy Center, Inc

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
5201003801MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1689246605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 LAURENCE AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022979",
            "telephone_number": "517-750-4777",
            "fax_number": "517-782-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 LAURENCE AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022979",
            "telephone_number": "517-750-4777",
            "fax_number": "517-782-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLAND",
        "first_name": "DAWN",
        "middle_name": "VERONICA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201003801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dawn@therapyjackson.com",
            "affiliation": "Y",
            "endpointDescription": "business email",
            "affiliationName": "Comprehensive Speech and Therapy Center, Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "business google email account",
            "address_1": "1001 Laurence Ave",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492022979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.