Individual provider Active NPI

Forrest Lewis Washburn, OTR/L

  • Occupational Therapist
  • Sterling Heights, MI
National Provider Identifier
1124794276
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201011381 Issued in MI
Practice address
13331 15 Mile Rd
Sterling Heights, MI 48312-4210
Phone
(586) 788-0702
NPI assigned
Aug 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201011381 MI Primary

Addresses

Primary practice location

13331 15 Mile Rd
Sterling Heights, MI 48312-4210

Mailing address

47001 Waters Edge LN Apt A205
Van Buren TWP, MI 48111-3152
Phone (269) 680-1169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210824002296 MI Practitioner - Occupational Therapist in Private Practice 0042615379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
RWW Outpatient Rehab Services, LLCGroup PAC ID 8729333521, 108 clinicians

Practice addresses (Care Compare)

3420 W Rd
Trenton, MI 48183-2323
Phone (734) 671-1923

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5201011381MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Level Eleven Saginaw CurrentSince Dec 2, 2021 Accepting new patients
RWW Outpatient Rehab Services, LLC CurrentSince Aug 23, 2021 Accepting new patients
RWW Outpatient Rehab Services, LLC Occupational Therapist CurrentSince Aug 23, 2021 Accepting new patients

Locations

5815 Bay Rd
Ste 400
Saginaw, MI 48604
Phone (989) 447-2538

13331 15 Mile Rd
Sterling Heights, MI 48312
Phone (586) 788-0702

3420 West Rd
Trenton, MI 48183
Phone (734) 215-9569

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1124794276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47001 WATERS EDGE LN APT A205",
            "city": "VAN BUREN TWP",
            "state": "MI",
            "postal_code": "481113152",
            "telephone_number": "269-680-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13331 15 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483124210",
            "telephone_number": "586-788-0702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHBURN",
        "first_name": "FORREST",
        "middle_name": "LEWIS",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201011381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.