Jorden Gary, OTRL

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201010468 Issued in MI

Practice address

400 North St W
Tawas City, MI 48763-9161

Phone

(989) 362-8645

NPI assigned

Mar 4, 2019

Sex

Male

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

Enrolled in MI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Powerback Rehabilitation LLC

  • Physical Therapist
  • Shelby Township, MI
  • NPI 1912226366

  Occupational Therapist

  Medicare reassignment NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761

  Occupational Therapist

  NPD

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1952869471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 NORTH ST W",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639161",
            "telephone_number": "989-362-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NORTH ST W",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487639161",
            "telephone_number": "989-362-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARY",
        "first_name": "JORDEN",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201010468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• FMG North Street West Michigan LLC
• Chelsea Gabrielle Fournier, LPTA
• Geri Lyn Fowler, RN, QIDP, QMHP
• Mark A Gallagher, D.O.
• Cathleen M Garner
• Audrey Mae Gekeler, RN
• Alexis Georgoff
• Kristen Leigh Gilbert, APRN, FNP-C
• Jolene Glotfelty, LBSW
• Haley Goodall

• Occupational Therapist in Tawas City, MI
• Providers in Tawas City, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.