Active NPI
Mutwali Masha
- Student in an Organized Health Care Education/Training Program
- Kalamazoo, MI
National Provider Identifier
1053909788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 5465 Gull Rd
Kalamazoo, MI 49048-1014 - Phone
- (269) 349-7631
- NPI assigned
- Jan 7, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | MI | Primary |
Addresses
Primary practice location
5465 Gull Rd
Kalamazoo, MI 49048-1014
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782259200000",
"number": "1053909788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8614 WESTWOOD CENTER DR FL 9",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822442",
"telephone_number": "703-847-8899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5465 GULL RD",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490481014",
"telephone_number": "269-349-7631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASHA",
"first_name": "MUTWALI",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-07",
"last_updated": "2026-06-24",
"certification_date": "2026-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.