Individual provider Active NPI

Melanie Britt Michaels, MPT

  • Physical Therapist
  • Eagle River, AK
National Provider Identifier
1184765448
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1653 Issued in AK
Practice address
10421 VFW Rd
Suite 103
Eagle River, AK 99577-8032
Phone
(907) 350-3657
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1653 AK Primary

Addresses

Primary practice location

10421 VFW Rd
Suite 103
Eagle River, AK 99577-8032

Mailing address

20201 New England Dr
Eagle River, AK 99577-7116
Phone (907) 622-1975

Other identifiers 1

IdentifierTypeStateIssuer
AK 1653OtherAKSTATE LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120507000092 ID Practitioner - Physical Therapist in Private Practice 3577588482 Practice locations: Boise, ID

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3100 S Vista Ave
Suite 104
Boise, ID 83705-7368
Phone (907) 350-3657

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
776WYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Anchorage Fracture and Orthopaedic Clinic, PC Past Accepting new patients
Mind, Body, Soul Physical Therapist PastSince Jan 1, 1990 Accepting new patients
Ronald S Higginbotham, DO PA PastSince Jul 2, 2014 Accepting new patients

Organizations & group practices 3

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184765448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20201 NEW ENGLAND DR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777116",
            "telephone_number": "907-622-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10421 VFW RD",
            "address_2": "SUITE 103",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778032",
            "telephone_number": "907-350-3657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAELS",
        "first_name": "MELANIE",
        "middle_name": "BRITT",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "AK 1653",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.