Individual provider Active NPI

Michael Bylsma, DPT

  • Physical Therapist
  • Three Rivers, MI
National Provider Identifier
1104378520
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501017059 Issued in MI
Practice address
501 S Health Pkwy
Three Rivers, MI 49093-8350
Phone
(269) 273-9682
Fax
(269) 273-9626
NPI assigned
Nov 2, 2016
Last updated
Nov 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501017059 MI Primary
Physical Therapist 225100000X 05011621A IN

Addresses

Primary practice location

501 S Health Pkwy
Three Rivers, MI 49093-8350

Mailing address

501 S Health Pkwy
Three Rivers, MI 49093-8350
Phone (269) 273-9682

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
05011621AINMDPhysical Therapist
5501017059MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1104378520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S HEALTH PKWY",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938350",
            "telephone_number": "269-273-9682",
            "fax_number": "269-273-9626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S HEALTH PKWY",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938350",
            "telephone_number": "269-273-9682",
            "fax_number": "269-273-9626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYLSMA",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017059",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05011621A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Three Rivers, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.