McKenzie Fruge

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT5221 Issued in AL

Practice address

5643 Sermon Rd S
Theodore, AL 36582-3608

Phone

(251) 660-1505

NPI assigned

Jan 29, 2020

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1811528706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40480",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366400480",
            "telephone_number": "251-434-3626",
            "fax_number": "251-445-2464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5643 SERMON RD S",
            "city": "THEODORE",
            "state": "AL",
            "postal_code": "365823608",
            "telephone_number": "251-660-1505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1601 Center St",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366041541",
            "country_code": "US",
            "telephone_number": "251-665-8201",
            "fax_number": "251-665-8211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRUGE",
        "first_name": "MCKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AL",
            "license": "OT5221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phillip Dueitt
• Kim Elizabeth Dyson, LPC
• Encore Rehabilitation Inc
• Tierra Ezell, ALC
• Vernell S Forman, MA./CCC/SLP
• Fruit of the Spirit Home Health Care
• Fuller Rehabilitation and Consulting Services, Inc.
• Susan Marie Gillispie, FNP
• David Greer, DPT
• Yolanda Hampton

• All providers in Theodore, AL
• Occupational Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.