Active NPI
Matthew Jon Graeber, OTR
- Occupational Therapist
- Coldwater, MI
National Provider Identifier
1932662483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 90 N Michigan Ave
Coldwater, MI 49036-1527 - Phone
- (517) 279-9808
- NPI assigned
- Apr 11, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201006064 | MI | |
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
90 N Michigan Ave
Coldwater, MI 49036-1527
Mailing address
15643 Katherine TRL
Marshall, MI 49068-9475
Phone (269) 986-3990
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5201006064 | Other | MI | BOARD OF OCCUPATIONAL THERAPISTS |
| 5201006064 | Other | MI | DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mattgraeber@sbcglobal.net |
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 |
|---|---|---|---|
| 5201006064 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1932662483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15643 KATHERINE TRL",
"city": "MARSHALL",
"state": "MI",
"postal_code": "490689475",
"telephone_number": "269-986-3990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 N MICHIGAN AVE",
"city": "COLDWATER",
"state": "MI",
"postal_code": "490361527",
"telephone_number": "517-279-9808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAEBER",
"first_name": "MATTHEW",
"middle_name": "JON",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-11",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201006064",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF OCCUPATIONAL THERAPISTS",
"identifier": "5201006064",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS",
"identifier": "5201006064",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mattgraeber@sbcglobal.net",
"affiliation": "N",
"address_1": "90 N Michigan Ave",
"city": "Coldwater",
"state": "MI",
"country_code": "US",
"postal_code": "490361527",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Coldwater, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.