Active NPI
Suja Mathew Joseph
- Physical Therapist
- Northville, MI
National Provider Identifier
1093216004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501008593
- Practice address
- 40708 Coachwood Cir
Northville, MI 48168-3280 - Phone
- (586) 944-6543
- NPI assigned
- Feb 24, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 5501008593 | MI | Primary |
Addresses
Primary practice location
40708 Coachwood Cir
Northville, MI 48168-3280
Mailing address
40708 Coachwood Cir
Northville, MI 48168-3280
Phone (586) 944-6543
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5501008593 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519430400000",
"number": "1093216004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40708 COACHWOOD CIR",
"city": "NORTHVILLE",
"state": "MI",
"postal_code": "481683280",
"telephone_number": "586-944-6543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40708 COACHWOOD CIR",
"city": "NORTHVILLE",
"state": "MI",
"postal_code": "481683280",
"telephone_number": "586-944-6543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "SUJA",
"middle_name": "MATHEW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-24",
"last_updated": "2018-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501008593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.