Individual provider Active NPI

Carrie Anne Collin, PTA

  • Physical Therapy Assistant
  • Fort Gratiot, MI
National Provider Identifier
1093518680
Registry record updated Mar 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
5502001802 Issued in MI
Practice address
5635 Lakeshore Rd
Fort Gratiot, MI 48059-2817
Phone
(810) 385-7447
NPI assigned
Mar 29, 2025
Last updated
Mar 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2025

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 5502001802 MI Primary

Addresses

Primary practice location

5635 Lakeshore Rd
Fort Gratiot, MI 48059-2817

Mailing address

161 Wells St
Croswell, MI 48422-1143
Phone (810) 304-0243

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
5502001802MIMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1743206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743206400000",
    "number": "1093518680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 WELLS ST",
            "city": "CROSWELL",
            "state": "MI",
            "postal_code": "484221143",
            "telephone_number": "810-304-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5635 LAKESHORE RD",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480592817",
            "telephone_number": "810-385-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIN",
        "first_name": "CARRIE",
        "middle_name": "ANNE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-29",
        "last_updated": "2025-03-29",
        "certification_date": "2025-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502001802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gratiot, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2025; 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.