Mitten State Pediatric Therapy LLC
NPI 1063021715ActiveOrganization· Occupational Therapist· Grand Rapids, MI
Occupational Therapist in Grand Rapids, Michigan, registered in NPPES in July 2020. The authorized official on file is Lindsay Dammar, Co-Owner. Enrolled in Medicare as part b supplier - physical/occupational therapy group in private practice.
Overview
| NPI | 1063021715 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 29, 2020 |
| Last updated in NPPES | Sep 11, 2023 |
| Certified by provider | Sep 11, 2023 |
Specialties and licenses
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Physical/Occupational Therapy Group in Private Practice (MI) |
|---|
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