Mitchel Babcock, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501017939 Issued in MI

Practice address

14261 Torrey Rd Ste C
Fenton, MI 48430-3329

Phone

(989) 295-3958

NPI assigned

Nov 29, 2016

Last updated

Jan 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Fitnesstx, PLLC

  • Physical Therapist
  • Fenton, MI
  • NPI 1497248207
  Medicare reassignment NPD

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1174066898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14261 TORREY RD STE C",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303329",
            "telephone_number": "989-295-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14261 TORREY RD STE C",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303329",
            "telephone_number": "989-295-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABCOCK",
        "first_name": "MITCHEL",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-29",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tessa Ash, RPH
• Associated Foot Clinic of Fenton, P.C.
• Athletico LTD (Athletico Physical Therapy)
• Authentically You Wellness LLC
• Ali Awada, PHARMD
• Back to Basics Physical Therapy LLC
• Back to Basics Wellness Center
• Blayne David Baggett
• Lisa Diane Baier, D.D.S.
• Mercedes A Bailey, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.