Active NPI
Robert Lawrence Gustin
- Occupational Therapist
- Rochester Hills, MI
National Provider Identifier
1194227025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201003825
- Practice address
- 3500 South Blvd W
Rochester Hills, MI 48309-3973 - Phone
- (248) 852-7800
- NPI assigned
- Mar 7, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 5201003825 | MI | Primary |
Addresses
Primary practice location
3500 South Blvd W
Rochester Hills, MI 48309-3973
Mailing address
3941 Long Meadow LN
Lake Orion, MI 48359-1465
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508058363 | Medicaid | MI |
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 |
|---|---|---|---|
| 5201003825 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520380800000",
"number": "1194227025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3941 LONG MEADOW LN",
"city": "LAKE ORION",
"state": "MI",
"postal_code": "483591465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 SOUTH BLVD W",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483093973",
"telephone_number": "248-852-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSTIN",
"first_name": "ROBERT",
"middle_name": "LAWRENCE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-07",
"last_updated": "2018-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201003825",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1508058363",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rochester Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.