Active NPI
Amy Grace Wagenmaker, CTRS
- Recreation Therapist
- Wyoming, MI
National Provider Identifier
1912884263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 85872
- Practice address
- 2016 Collingwood Ave SW
Wyoming, MI 49519-1648 - Phone
- (616) 690-3158
- NPI assigned
- Aug 19, 2025
- 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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 85872 | Primary |
Addresses
Primary practice location
2016 Collingwood Ave SW
Wyoming, MI 49519-1648
Mailing address
2016 Collingwood Ave SW
Wyoming, MI 49519-1648
Phone (616) 690-3158
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755561600000",
"number": "1912884263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2016 COLLINGWOOD AVE SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495191648",
"telephone_number": "616-690-3158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2016 COLLINGWOOD AVE SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495191648",
"telephone_number": "616-690-3158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGENMAKER",
"first_name": "AMY",
"middle_name": "GRACE",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-19",
"last_updated": "2025-08-19",
"certification_date": "2025-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": null,
"license": "85872",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.