Active NPI
Carlene Grace Dardas, COTAL
- Occupational Therapy Assistant
- West Branch, MI
National Provider Identifier
1851891394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5202008011
- Practice address
- 2463 S M 30
West Branch, MI 48661-9312 - Phone
- (989) 345-3660
- NPI assigned
- Feb 20, 2018
- Last updated
- Feb 20, 2018
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5202008011 | MI | Primary |
Addresses
Primary practice location
2463 S M 30
West Branch, MI 48661-9312
Mailing address
1680 N Jones Rd
Essexville, MI 48732-1586
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5202008011 | MI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519084800000",
"number": "1851891394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1680 N JONES RD",
"city": "ESSEXVILLE",
"state": "MI",
"postal_code": "487321586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2463 S M 30",
"city": "WEST BRANCH",
"state": "MI",
"postal_code": "486619312",
"telephone_number": "989-345-3660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DARDAS",
"first_name": "CARLENE",
"middle_name": "GRACE",
"name_prefix": "Ms.",
"credential": "COTAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-20",
"last_updated": "2018-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MI",
"license": "5202008011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Branch, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.