Alicia Konecny
Individual provider Active NPI Physical Therapy Assistant · Grand Blanc, MI
NPI 1144634015 · NPPES record last updated Jun 18, 2014
Key facts
- NPI
- 1144634015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 5502000718 (MI)
- Practice address
- 8481 Holly Rd
Grand Blanc, MI 48439-1812 - Phone
- (810) 694-6382
- NPI assigned
- Jun 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5502000718 | MI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5502000718 | MI | Yes |
Addresses
Primary practice location
8481 Holly Rd
Grand Blanc, MI 48439-1812
Mailing address
8481 Holly Rd
Grand Blanc, MI 48439-1812
NPI Registry JSON
{
"created_epoch": "1403049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403049600000",
"number": "1144634015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8481 HOLLY RD",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484391812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8481 HOLLY RD",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484391812",
"telephone_number": "810-694-6382"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KONECNY",
"first_name": "ALICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-18",
"last_updated": "2014-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MI",
"license": "5502000718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Blanc, MI
- Kyle Thompson Knight
- Cody Martin Knuppenburg
- Christopher Kocharians
- Evan Kohler
- Prasad Kommareddi
- Carla Anne Koon
- Olivia Korhonen
- Joel Fredric Kortge
- Erica Kovacs
- Sherry Lin Kowal
All providers in Grand Blanc, MI · Physical Therapy Assistant in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.