Lisa Ann Mervenne, O.T.R.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5201000452 Issued in MI

Practice address

2520 Lake Michigan Dr NW
Grand Rapids, MI 49504-4696

Phone

(616) 735-6050

NPI assigned

Oct 5, 2007

Last updated

Oct 5, 2007By 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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1922296730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4075 SILVERGRASS DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259552",
            "telephone_number": "616-447-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 LAKE MICHIGAN DR NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044696",
            "telephone_number": "616-735-6050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERVENNE",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "O.T.R.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "5201000452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Whetter Mersman, PA
• Courtney Mertel
• Deborah Marie Mervau Scheidel, OTR
• Alexander Mervenne, CAA
• Gregory S Mervenne, MD
• Gagindip Merwar, MD
• Daniel Allen Mesaros, CAA
• Shelby Taylor Meshinski, MD
• Jackson Mesick, DO
• Katherine Mesko, OTRL

• Skilled Nursing Facility in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.