Active NPI
Caleb John Marvin, CTRS
- Recreation Therapist
- Ypsilanti, MI
National Provider Identifier
1649711102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 68419
- Practice address
- 7794 Paint Creek Dr
Ypsilanti, MI 48197-6139 - Phone
- (734) 352-3543
- NPI assigned
- Mar 16, 2017
- Last updated
- Mar 16, 2017
- 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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 68419 | MI | Primary |
Addresses
Primary practice location
7794 Paint Creek Dr
Ypsilanti, MI 48197-6139
Mailing address
160 Whipple St
South Lyon, MI 48178-1114
Phone (989) 205-9663
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68419 | MI | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489622400000",
"number": "1649711102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 WHIPPLE ST",
"city": "SOUTH LYON",
"state": "MI",
"postal_code": "481781114",
"telephone_number": "989-205-9663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7794 PAINT CREEK DR",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481976139",
"telephone_number": "734-352-3543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARVIN",
"first_name": "CALEB",
"middle_name": "JOHN",
"credential": "CTRS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-16",
"last_updated": "2017-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "MI",
"license": "68419",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.