Individual provider Active NPI

Michele Marie Vennetti, PT

  • Physical Therapist
  • Youngstown, OH
National Provider Identifier
1124878467
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009064 Issued in OH
Practice address
7630 Southern Blvd
Youngstown, OH 44512-5633
Phone
(330) 729-8262
Fax
(330) 729-8269
NPI assigned
Mar 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT009064 OH Primary

Addresses

Primary practice location

7630 Southern Blvd
Youngstown, OH 44512-5633

Mailing address

100 Debartolo PL Ste 200
Youngstown, OH 44512-6095
Phone (330) 729-8145

Other practice location 1

250 Debartolo Pl Ste 1100
Youngstown, OH 44512-7004
Phone (234) 287-6660

Other identifiers 1

IdentifierTypeStateIssuer
0048789MedicaidOH

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Surgery Center at Southwoods, LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1124878467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DEBARTOLO PL STE 200",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445126095",
            "telephone_number": "330-729-8145",
            "fax_number": "330-965-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7630 SOUTHERN BLVD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445125633",
            "telephone_number": "330-729-8262",
            "fax_number": "330-729-8269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Debartolo Pl Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Youngstown",
            "state": "OH",
            "postal_code": "445127004",
            "country_code": "US",
            "telephone_number": "234-287-6660",
            "fax_number": "234-287-6669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENNETTI",
        "first_name": "MICHELE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-26",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT009064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0048789",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.