Jennifer A Kocik

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201007440 Issued in MI

Practice address

21210 Alexander St
Saint Clair Shores, MI 48081-1824

Phone

(586) 899-9744

NPI assigned

Dec 7, 2020

Last updated

Dec 7, 2020By the provider in NPPES

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

Specialty

Occupational Therapist in Private Practice

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lumen Pediatric Therapy, LLC

  • Speech-Language Pathologist
  • Saint Clair Shores, MI
  • NPI 1407573942

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1699371401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21210 ALEXANDER ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811824",
            "telephone_number": "586-899-9744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21210 ALEXANDER ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811824",
            "telephone_number": "586-899-9744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCIK",
        "first_name": "JENNIFER",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201007440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kathleen Kneiser, M.D.
• Julia Joanna Knobelsdorf, MD
• George Stephen Knowlton, D.D.S.
• Mary Kay Knox
• Megan Marie Knuth, DO
• Thomas Frederick Koehler, O.D.
• Jeffrey Koenigbauer, D.C.
• Norma R Koleta, CRNA
• Bradley Richard Koliba
• Nancy Kominiarek, PA

• Occupational Therapist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.