Individual provider Active NPI

Darrell James Whitbeck, OT

  • Occupational Therapist
  • Canandaigua, NY
National Provider Identifier
1487718300
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
012505-1 Issued in NY
Practice address
5415 N Bloomfield Rd
Happiness House
Canandaigua, NY 14424-7964
Phone
(585) 394-9510
Fax
(585) 394-5326
NPI assigned
Dec 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 012505-1 NY Primary
Neurorehabilitation Occupational Therapist 225XN1300X 012505-1 NY
Pediatric Occupational Therapist 225XP0200X 012505-1 NY

Addresses

Primary practice location

5415 N Bloomfield Rd
Happiness House
Canandaigua, NY 14424-7964

Mailing address

55 Groton Pkwy
Rochester, NY 14623-4532

Other identifiers 1

IdentifierTypeStateIssuer
01635592MedicaidNY

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

LicenseStateTypeSpecialty
012505-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449705600000",
    "number": "1487718300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 GROTON PKWY",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146234532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 N BLOOMFIELD RD",
            "address_2": "HAPPINESS HOUSE",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144247964",
            "telephone_number": "585-394-9510",
            "fax_number": "585-394-5326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITBECK",
        "first_name": "DARRELL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2015-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "012505-1",
            "primary": true
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "NY",
            "license": "012505-1",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "012505-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01635592",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.