Individual provider Active NPI

Rowena Marjorie Spafford, P.T.

  • Physical Therapist
  • Stevensville, MI
National Provider Identifier
1043415581
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501004618 Issued in MI
Practice address
2654 W John Beers Rd
Stevensville, MI 49127-1213
Phone
(269) 428-1440
Fax
(269) 428-3992
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501004618 MI Primary

Addresses

Primary practice location

2654 W John Beers Rd
Stevensville, MI 49127-1213

Mailing address

3353 Celina Ave
Saint Joseph, MI 49085-3734
Phone (269) 556-9596

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

LicenseStateTypeSpecialty
5501004618MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043415581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3353 CELINA AVE",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490853734",
            "telephone_number": "269-556-9596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2654 W JOHN BEERS RD",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491271213",
            "telephone_number": "269-428-1440",
            "fax_number": "269-428-3992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAFFORD",
        "first_name": "ROWENA",
        "middle_name": "MARJORIE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501004618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevensville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.