JESSE BRYAN NICODEMUS


Address: 2320 E Beltline Ave Se, Grand Rapids, MI 49546-5906
Phone: 6168318666

JESSE BRYAN NICODEMUS (NPI# 1386114734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1386114734
Entity Type Individual
Full Name JESSE BRYAN NICODEMUS
Credential MOT
Practice Address 2320 E Beltline Ave Se
Grand Rapids
MI 49546-5906
Practice Telephone 6168318666
Mailing Telephone 6168318666
Enumeration Date 2018-11-28
Last Update Date 2018-11-28
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 225X00000X Occupational Therapist 201009340 MI Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Office Location

Street Address 2320 E BELTLINE AVE SE
City GRAND RAPIDS
State MI
Zip Code 49546-5906

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205878998 Heartland of Grand Rapids Mi LLC Skilled Nursing Facility 2320 E Beltline Ave Se, Grand Rapids, MI 49546-5906 2006-06-10
1316400120 Lisa Wiersma Speech-Language Pathologist 2320 E Beltline Ave Se, Grand Rapids, MI 49546-5906 2019-04-09
1821554031 Mary Vanderwal Occupational Therapy Assistant 2320 E Beltline Ave Se, Grand Rapids, MI 49546-5906 2019-02-12
1114497567 Jason Toma Physical Medicine & Rehabilitation 2320 E Beltline Ave Se, Grand Rapids, MI 49546-5906 2018-11-28
1205325834 Grand Rapids Snf, LLC Skilled Nursing Facility 2320 E Beltline Ave Se, Grand Rapids, MI 49546 2018-05-09
1255871968 Lisa A Mitchell Nurse Practitioner 2320 E Beltline Ave Se, Heartland Care Partners, Grand Rapids, MI 49546-5906 2017-02-28
1447596267 Gregory A. Kuldanek P.C. Internal Medicine 2320 E Beltline Ave Se, Grand Rapids, MI 49546-5906 2012-12-26
1710144894 Sarah C Hall Speech-Language Pathologist 2320 E Beltline Ave Se, Grand Rapids, MI 49546-5906 2008-05-17

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437762986 Amanda Mae Ostrom Speech-Language Pathologist 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 2020-08-25
1063075562 Kelly Lynn Ibarra Counselor 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 2019-04-19
1891257036 Jessica Matthews LLC Counselor 4127 Embassy Drive Se, Grand Rapids, MI 49546 2019-04-05
1326518531 Neah Morgan Technician 4220 Burton St Se, Grand Rapids, MI 49546 2018-11-29
1316430267 Michael John Benskey Case Manager/Care Coordinator 4065 Saladin St Se, Grand Rapids, MI 49546 2018-06-14
1679062772 Smile Cascade, P.C. Clinic/Center 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 2018-05-03
1720583289 Jeromy Krogman Counselor 826 Parchment Drive Se, Grand Rapids, MI 49546 2018-03-27
1841792660 Affordable Hearing Clinic Hearing Instrument Specialist 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 2018-03-07
1689176133 Kelly Pines Physical Therapist 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 2018-03-01
1467971440 Deanna Elizabeth Saenz Social Worker 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 2017-09-12
Find all providers in zip 49546

Taxonomy Information

Taxonomy Code 225X00000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Occupational Therapist

Taxonomy Definition

An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1376185199 Beth Arce Occupational Therapist 245 Cherry St Se Suite 302, Grand Rapids, MI 49503 2019-10-14
1033771522 Abigail Peters Occupational Therapist 1845 Boston St Se, Grand Rapids, MI 49506-4400 2019-07-03
1790340719 Heather Anne Fox Occupational Therapist Marywood, 111 Lakeside Dr Ne, Grand Rapids, MI 49503 2019-05-06
1508342403 Kelsey Elizabeth Ewald Occupational Therapist 910 Hovey St Sw, Grand Rapids, MI 49504-6230 2018-07-13
1386138113 Judith Helen Siegert Occupational Therapist 4450 Cascade Rd Se Ste 200, Grand Rapids, MI 49546-3633 2018-06-15
1689164535 Kerry Ann Macdonald Occupational Therapist 1147 Sibley St Nw, Grand Rapids, MI 49504-5459 2018-05-16
1821595711 Karen Amal Farhat-hendricks Occupational Therapist 3683 Maplebrook Dr Nw, Grand Rapids, MI 49534-2709 2018-04-09
1003310848 Jessica Michelle Flood Occupational Therapist 2750 E Beltline Ave Ne # Mc279, Grand Rapids, MI 49525-8614 2018-03-19
1043713175 Stacey Marie Schaub Occupational Therapist 750 Fuller Avenue, Grand Rapids, MI 49503 2018-03-15
1467955906 Rachelle Schultz Occupational Therapist 4234 Shadowlawn Ct Ne, Grand Rapids, MI 49525-1921 2018-03-12
Find all providers in GRAND RAPIDS

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City GRAND RAPIDS
Zip Code 49546

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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