Active NPI
Michael Debruine, CTRS
- Recreation Therapist
- Whitehall, MI
National Provider Identifier
1457061228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 83939
- Practice address
- 137 Holton Whitehall Rd
Whitehall, MI 49461-9543 - Phone
- (231) 893-1462
- NPI assigned
- Dec 1, 2022
- 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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 83939 | Primary |
Addresses
Primary practice location
137 Holton Whitehall Rd
Whitehall, MI 49461-9543
Mailing address
3152 Peregrine Dr NE Ste 115
Grand Rapids, MI 49525-9723
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Professional Services, Inc. | Past | Accepting new patients | |
| Nrmi, LLC | Past | Accepting new patients |
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.
-
- Physical Disabilities Residential Treatment Facility
- Whitehall, MI
- NPI 1598946170
-
- Physical Disabilities Residential Treatment Facility
- Whitehall, MI
- NPI 1184017501
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669852800000",
"number": "1457061228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3152 PEREGRINE DR NE STE 115",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "137 HOLTON WHITEHALL RD",
"city": "WHITEHALL",
"state": "MI",
"postal_code": "494619543",
"telephone_number": "231-893-1462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEBRUINE",
"first_name": "MICHAEL",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-01",
"last_updated": "2022-12-01",
"certification_date": "2022-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": null,
"license": "83939",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whitehall, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.