Active NPI
Danielle Marie Hackert, OTRL
- Pediatric Occupational Therapist
- Grand Rapids, MI
National Provider Identifier
1730745753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 5201009904
- Practice address
- 2125 43Rd St SE # Aptk-12
Grand Rapids, MI 49508-3773 - Phone
- (609) 802-2100
- NPI assigned
- May 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 5201009904 | MI | Primary |
Addresses
Primary practice location
2125 43Rd St SE # Aptk-12
Grand Rapids, MI 49508-3773
Mailing address
2125 43Rd St SE # Aptk-12
Grand Rapids, MI 49508-3773
Phone (609) 802-2100
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5201009904 | MI | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557878400000",
"number": "1730745753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2125 43RD ST SE # APTK-12",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495083773",
"telephone_number": "609-802-2100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2125 43RD ST SE # APTK-12",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495083773",
"telephone_number": "609-802-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HACKERT",
"first_name": "DANIELLE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-15",
"last_updated": "2019-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "MI",
"license": "5201009904",
"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 May 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.