Active NPI
Randall Shinaberry, MS OTRL
- Occupational Therapist
- Mt Pleasant, MI
National Provider Identifier
1881070845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5201009019
- Practice address
- 2479 Rosewood N
Ste a
Mt Pleasant, MI 48858-5004 - Phone
- (989) 289-3755
- NPI assigned
- Jul 31, 2015
- 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 | 5201009019 | MI | Primary |
Addresses
Primary practice location
2479 Rosewood N
Ste a
Mt Pleasant, MI 48858-5004
Mailing address
2479 Rosewood N
Ste a
Mt Pleasant, MI 48858-5004
Phone (989) 289-3755
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5201009019 | MI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438300800000",
"number": "1881070845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2479 ROSEWOOD N",
"address_2": "STE A",
"city": "MT PLEASANT",
"state": "MI",
"postal_code": "488585004",
"telephone_number": "989-289-3755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2479 ROSEWOOD N",
"address_2": "STE A",
"city": "MT PLEASANT",
"state": "MI",
"postal_code": "488585004",
"telephone_number": "989-289-3755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHINABERRY",
"first_name": "RANDALL",
"name_prefix": "Mr.",
"credential": "MS OTRL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-31",
"last_updated": "2015-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MI",
"license": "5201009019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mt Pleasant, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.