Individual provider Active NPI

Michele Ann Lough, P.T.

  • Specialist
  • Santa Rosa, CA
National Provider Identifier
1124208806
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
28445 Issued in CA
Practice address
2449 Summerfield Rd
Santa Rosa, CA 95405-7815
Phone
(707) 523-7313
Fax
(707) 523-7307
NPI assigned
Nov 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 28445 CA Primary

Addresses

Primary practice location

2449 Summerfield Rd
Santa Rosa, CA 95405-7815

Mailing address

416 Ashbury Ave
Santa Rosa, CA 95404-5209
Phone (707) 206-2020

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

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1124208806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 ASHBURY AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045209",
            "telephone_number": "707-206-2020",
            "fax_number": "707-523-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2449 SUMMERFIELD RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057815",
            "telephone_number": "707-523-7313",
            "fax_number": "707-523-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUGH",
        "first_name": "MICHELE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "28445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.