Active NPI
Morgan Rudolph
- Occupational Therapist
- Washington, MI
National Provider Identifier
1104501576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201014197
- Practice address
- 65800 Van Dyke Rd
Washington, MI 48095-2041 - Phone
- (586) 945-4449
- NPI assigned
- Jun 21, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5201014197 | MI | Primary |
Addresses
Primary practice location
65800 Van Dyke Rd
Washington, MI 48095-2041
Mailing address
8538 Elizabeth Ann St
Shelby TWP, MI 48317-4326
Phone (586) 248-2307
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250512000728 | MI | Practitioner - Occupational Therapist in Private Practice | 7719404904 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5201014197 | MI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Milestones Autism Center LLC | Occupational Therapist | Current | Accepting new patients |
| Milestones Autism Center LLC | Occupational Therapist | Current | Accepting new patients |
Locations
65800 Van Dyke Rd
Washington, MI 48095
Phone (586) 945-4449
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Washington, MI
- NPI 1629880737
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745539200000",
"number": "1104501576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8538 ELIZABETH ANN ST",
"city": "SHELBY TWP",
"state": "MI",
"postal_code": "483174326",
"telephone_number": "586-248-2307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65800 VAN DYKE RD",
"city": "WASHINGTON",
"state": "MI",
"postal_code": "480952041",
"telephone_number": "586-945-4449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDOLPH",
"first_name": "MORGAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-21",
"last_updated": "2025-04-25",
"certification_date": "2025-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201014197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.