NPIMap

Organization Active NPI

Sensory Systems Clinic West, PLC

  • Occupational Therapist
  • Wayland, MI
National Provider Identifier
1699047050
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201007520 Issued in MI
Legal business name
SENSORY SYSTEMS CLINIC WEST, PLC
Practice address
145 S Main St Ste 4
Wayland, MI 49348-1702
Phone
(269) 792-2353
Fax
(269) 792-2847
NPI assigned
Feb 1, 2012
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Peggy Ann McCourryNPI 1871556555
Title
Owner/OT
Phone
(269) 792-2353

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X 5201007520 MI Primary

Addresses

Primary practice location

145 S Main St Ste 4
Wayland, MI 49348-1702

Mailing address

145 S Main St Ste 4
Wayland, MI 49348-1702
Phone (269) 792-2353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120221000642 MI Part B Supplier - Clinic/Group Practice 3971761081 Receives reassigned benefits from 1 practitioner
Practice locations: Wayland, MI

National Provider Directory

National Provider Directory

Locations

118 W Maple St
Wayland, MI 49348
Phone (269) 792-2353

145 S Main St
Ste 4
Wayland, MI 49348
Phone (269) 792-2353

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1328054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1699047050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 S MAIN ST STE 4",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493481702",
            "telephone_number": "269-792-2353",
            "fax_number": "269-792-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 S MAIN ST STE 4",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493481702",
            "telephone_number": "269-792-2353",
            "fax_number": "269-792-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENSORY SYSTEMS CLINIC WEST, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-01",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "MCCOURRY",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/OT",
        "authorized_official_telephone_number": "269-792-2353"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201007520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.