Organization Active NPI

Actionphysicaltherapyyoga&Wellnesscenterinc.

  • Physical Therapist
  • Portage, MI
National Provider Identifier
1104038850
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2379 Issued in MI
Legal business name
ACTIONPHYSICALTHERAPYYOGA&WELLNESSCENTERINC.
Practice address
5811 S Westnedge Ave
Portage, MI 49002-1456
Phone
(269) 217-0670
Fax
(000) 000-0000
NPI assigned
May 4, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Raj Sharma
Title
President
Phone
(269) 217-0670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2379 MI Primary

Addresses

Primary practice location

5811 S Westnedge Ave
Portage, MI 49002-1456

Mailing address

3700 Swan Creek Dr
Portage, MI 49024-5519
Phone (269) 217-0670

National Provider Directory

National Provider Directory

Locations

5811 S Westnedge Ave
Portage, MI 49002
Phone (269) 217-0670

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104038850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 SWAN CREEK DR",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245519",
            "telephone_number": "269-217-0670",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5811 S WESTNEDGE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021456",
            "telephone_number": "269-217-0670",
            "fax_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIONPHYSICALTHERAPYYOGA&WELLNESSCENTERINC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "RAJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-217-0670"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "2379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.