Mitten State Pediatric Therapy LLC
NPI 1063021715 · Occupational Therapist · Grand Rapids, MI
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Mitten State Pediatric Therapy LLC is a Occupational Therapist organization in Grand Rapids, MI (NPI 1063021715).
Provider details
- NPI number
- 1063021715
- Entity type
- Organization
- Primary specialty
- Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Lindsay Dammar, Co-Owner(248) 535-4666
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Allopathic & Osteopathic Physicians
- Physical Therapist225100000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Speech-Language Pathologist235Z00000X
Speech, Language and Hearing Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-07-29
- Last updated
- 2023-09-11
- Certified
- 2023-09-11
Frequently asked questions
- What is Mitten State Pediatric Therapy LLC's NPI number?
- Mitten State Pediatric Therapy LLC's National Provider Identifier (NPI) is 1063021715, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mitten State Pediatric Therapy LLC?
- Mitten State Pediatric Therapy LLC is classified in the NPPES registry as Occupational Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Mitten State Pediatric Therapy LLC located?
- Mitten State Pediatric Therapy LLC's practice location on file with NPPES is 5258 Plainfield Ave Ne Ste a, Grand Rapids, MI 49525-1092.
- What is Mitten State Pediatric Therapy LLC's phone number?
- The practice phone number listed in the NPPES registry for Mitten State Pediatric Therapy LLC is (616) 466-4068.
- Does Mitten State Pediatric Therapy LLC accept Medicare?
- Mitten State Pediatric Therapy LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Mitten State Pediatric Therapy LLC?
- The authorized official listed on Mitten State Pediatric Therapy LLC's NPPES record is Lindsay Dammar, Co-Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mitten State Pediatric Therapy LLC's NPI active?
- Yes — Mitten State Pediatric Therapy LLC's NPI (1063021715) is active in the NPPES registry as of the last update on 2023-09-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.