Active NPI
Rock Steady Boxing Mid Michigan
- Rehabilitation Practitioner
- Midland, MI
National Provider Identifier
1104354349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Legal business name
- ROCK STEADY BOXING MID MICHIGAN
- Practice address
- 1914 S Saginaw Rd Apt 408
Midland, MI 48640-6808 - Phone
- (989) 486-1154
- NPI assigned
- Jun 1, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stacey Lynne Hannah
- Title
- Owner/Head Coach
- Phone
- (989) 486-1154
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
1914 S Saginaw Rd Apt 408
Midland, MI 48640-6808
Mailing address
1914 S Saginaw Rd Apt 408
Midland, MI 48640-6808
National Provider Directory
National Provider DirectoryLocations
1914 S Saginaw Rd
Apt 408
Midland, MI 48640
Phone (989) 486-1154
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496275200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1496275200000",
"number": "1104354349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1914 S SAGINAW RD APT 408",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1914 S SAGINAW RD APT 408",
"city": "MIDLAND",
"state": "MI",
"postal_code": "486406808",
"telephone_number": "989-486-1154"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROCK STEADY BOXING MID MICHIGAN",
"organizational_subpart": "NO",
"enumeration_date": "2017-06-01",
"last_updated": "2017-06-01",
"status": "A",
"authorized_official_last_name": "HANNAH",
"authorized_official_first_name": "STACEY",
"authorized_official_middle_name": "LYNNE",
"authorized_official_title_or_position": "OWNER/HEAD COACH",
"authorized_official_telephone_number": "989-486-1154"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Midland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.