Individual provider Active NPI

Michelle Renee Emond

  • Physical Therapy Assistant
  • Canon City, CO
National Provider Identifier
1073808366
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA LICENSE APPLICAN Issued in CA
Practice address
344 N Cottonwood Ave
Canon City, CO 81212-2509
Phone
(719) 429-1923
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA LICENSE APPLICAN CA Primary

Addresses

Primary practice location

344 N Cottonwood Ave
Canon City, CO 81212-2509

Mailing address

344 N Cottonwood Ave
Canon City, CO 81212-2509
Phone (719) 429-1923

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
PTA LICENSE APPLICANCAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1073808366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 N COTTONWOOD AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122509",
            "telephone_number": "719-429-1923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "344 N COTTONWOOD AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122509",
            "telephone_number": "719-429-1923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMOND",
        "first_name": "MICHELLE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "PTA LICENSE APPLICAN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; 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.