Miranda Lane Cleary, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018435 Issued in MI

Practice address

350 N Main St Ste 180
Chelsea, MI 48118-1635

Phone

(734) 475-9925

Fax

(734) 475-9927

NPI assigned

Nov 15, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physical Therapy Services of West Michigan LLC

  • Physical Therapist
  • Kalamazoo, MI
  • NPI 1508895806
  NPD (past)

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1124531918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N MAIN ST STE 180",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181635",
            "telephone_number": "734-475-9925",
            "fax_number": "734-475-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N MAIN ST STE 180",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181635",
            "telephone_number": "734-475-9925",
            "fax_number": "734-475-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARY",
        "first_name": "MIRANDA",
        "middle_name": "LANE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN LICENSE",
            "identifier": "5501018435",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cherry Optometry, P.C.
• Anthony Jungho Choe, M.D.
• David Bruno Cichon, MS OTR/L
• Kathleen Cipicchio, RN
• George Warren Clark, LMSW
• Marian Cohen, MSW
• Bailey Marie Coleman, PT, DPT
• Jennifer W Collin, MD
• Amanda Marie Connon, LLP
• James M Cooke, MD

• Physical Therapist in Chelsea, MI
• Providers in Chelsea, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.