Active NPI
Dustin White, OTR/L
- Occupational Therapist
- Marshall, MI
National Provider Identifier
1023405735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 339276
- Practice address
- 879 E Michigan Ave
Marshall, MI 49068-2045 - Phone
- (269) 781-4251
- NPI assigned
- Apr 20, 2015
- Last updated
- Nov 27, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Feeding, Eating & Swallowing Occupational Therapy Assistant | 224ZF0002X | |||
| Occupational Therapist | 225X00000X | 339276 | MI | Primary |
Addresses
Primary practice location
879 E Michigan Ave
Marshall, MI 49068-2045
Mailing address
1734 Fayette CT
Portage, MI 49002-7506
Phone (269) 744-2840
Other practice location 1
2575 N Drake Rd
Kalamazoo, MI 49006-1358
Phone (269) 342-0206
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mlmarshall.tpm@encorerehabilitation.com | Direct | Marshall Opco, LLC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 339276 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1429488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1023405735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1734 FAYETTE CT",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490027506",
"telephone_number": "269-744-2840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "879 E MICHIGAN AVE",
"city": "MARSHALL",
"state": "MI",
"postal_code": "490682045",
"telephone_number": "269-781-4251"
}
],
"practiceLocations": [
{
"address_1": "2575 N Drake Rd",
"address_purpose": "LOCATION",
"city": "Kalamazoo",
"state": "MI",
"postal_code": "490061358",
"country_code": "US",
"telephone_number": "269-342-0206",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITE",
"first_name": "DUSTIN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-20",
"last_updated": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "224ZF0002X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant, Feeding, Eating & Swallowing",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "339276",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mlmarshall.tpm@encorerehabilitation.com",
"affiliation": "Y",
"endpointDescription": "work email",
"affiliationName": "Marshall Opco, LLC",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "879 E Michigan Ave",
"city": "Marshall",
"state": "MI",
"country_code": "US",
"postal_code": "490682045",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Marshall, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.