Individual provider Active NPI

Andrew Squire

  • Physical Therapist
  • Ann Arbor, MI
National Provider Identifier
1083965958
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501016089 Issued in MI
Practice address
2058 S State St
Suite 500
Ann Arbor, MI 48104-4786
Phone
(734) 913-0300
NPI assigned
Oct 2, 2012
Last updated
Oct 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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 5501016089 MI Primary

Addresses

Primary practice location

2058 S State St
Suite 500
Ann Arbor, MI 48104-4786

Mailing address

2058 S State St
Suite 500
Ann Arbor, MI 48104-4786

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": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1083965958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2058 S STATE ST",
            "address_2": "SUITE 500",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2058 S STATE ST",
            "address_2": "SUITE 500",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044786",
            "telephone_number": "734-913-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SQUIRE",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; 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.