Derek Jordan Adams, PTA
Individual provider Active NPI Physical Therapy Assistant · Three Rivers, MI
NPI 1013432178 · NPPES record last updated Aug 10, 2017
Key facts
- NPI
- 1013432178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 5502005311 (MI)
- Practice address
- 501 S Health Pkwy
Three Rivers, MI 49093-8350 - Phone
- (296) 278-9682
- Fax
- (296) 273-9626
- NPI assigned
- Aug 10, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5502005311 | MI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5502005311 | MI | Yes |
Addresses
Primary practice location
501 S Health Pkwy
Three Rivers, MI 49093-8350
Mailing address
701 S Health Pkwy
Three Rivers, MI 49093-8352
Phone (269) 278-1145
Other providers in Three Rivers, MI
- Sandhya Abraham
- Joseph Michael Adams
- Muhammad S. Ahmed
- Heidi Lynn Alexander
- Janie Beth Allgor
- Andrea Tidy-Clarisa Allman
All providers in Three Rivers, MI · Physical Therapy Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.