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1124328190 NPI number — LAURA E MCGINNIS MS OTRL

NPI Number: 1124328190
Health Care Provider/Practitioner: LAURA E MCGINNIS MS OTRL

Information about “1124328190” NPI (LAURA E MCGINNIS MS OTRL) exists in 1124328190 in HTML format HTML  |  1124328190 in plain Text format TXT  |  1124328190 in PDF (Portable Document Format) PDF  |  1124328190 in an XML format XML  formats.

NPI Number : 1124328190 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124328190",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCGINNIS",
    "FirstName": "LAURA",
    "MiddleName": "E",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MS OTRL",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MILLER",
    "OtherFirstName": "LAURA",
    "OtherMiddleName": "E",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": "COTA",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "9900 MEREDITH GRADE RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HARRISON",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48625-7827",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "989-539-6868",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1222 NORTH DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MOUNT PLEASANT",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48858-3200",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "989-772-2957",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/25/2010",
    "LastUpdateDate": "03/06/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "02/21/2018",
    "NPIReactivationDate": "03/06/2018",
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "224Z00000X",
          "TaxonomyName": "Occupational Therapy Assistant",
          "LicenseNumber": "5202006878",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": "5201008200",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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