Active NPI
Pamela Brioso Gonzales-Lanac, PT
- Physical Therapist
- Troy, MI
National Provider Identifier
1003070632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501012837
- Practice address
- Beaumont Hospital-Troy
44201 Dequindre Rd Ste 203a
Troy, MI 48085-1117 - Phone
- (248) 964-4014
- NPI assigned
- Jul 14, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501012837 | MI | Primary |
Addresses
Primary practice location
Beaumont Hospital-Troy
44201 Dequindre Rd Ste 203a
Troy, MI 48085-1117
Mailing address
Beaumont Hospital
44201 Dequindre Rd Ste 203a
Troy, MI 48085-1117
Phone (248) 964-4014
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519344000000",
"number": "1003070632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BEAUMONT HOSPITAL",
"address_2": "44201 DEQUINDRE RD STE 203A",
"city": "TROY",
"state": "MI",
"postal_code": "480851117",
"telephone_number": "248-964-4014",
"fax_number": "248-964-8099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BEAUMONT HOSPITAL-TROY",
"address_2": "44201 DEQUINDRE RD STE 203A",
"city": "TROY",
"state": "MI",
"postal_code": "480851117",
"telephone_number": "248-964-4014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALES-LANAC",
"first_name": "PAMELA",
"middle_name": "BRIOSO",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-14",
"last_updated": "2018-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501012837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.