Individual provider Active NPI

Michael Anthony Morin, PTA

  • Physical Therapy Assistant
  • San Antonio, TX
National Provider Identifier
1164634671
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2058260 Issued in TX
Practice address
15600 San Pedro Ave
Suite 307
San Antonio, TX 78232
Phone
(210) 494-2343
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2058260 TX Primary
Physical Therapy Assistant 225200000X 000861 CT

Addresses

Primary practice location

15600 San Pedro Ave
Suite 307
San Antonio, TX 78232

Mailing address

P.O. Box 8262
Manchester, CT 06040-0262
Phone (860) 550-3416

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
2058260TXMDPhysical Therapy Assistant
000861CTMDWomen's Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164634671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 8262",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060400262",
            "telephone_number": "860-550-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 SAN PEDRO AVE",
            "address_2": "SUITE 307",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78232",
            "telephone_number": "210-494-2343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORIN",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2058260",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CT",
            "license": "000861",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.