Active NPI
Michele Terese Vita, DPT, OCS
- Physical Therapist
- Lackland a F B, TX
National Provider Identifier
1184835050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 2200 Bergquist Dr Ste 1
Attn Credentials
Lackland a F B, TX 78236-9908 - Phone
- (210) 292-6225
- NPI assigned
- May 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | IL | Primary |
Addresses
Primary practice location
2200 Bergquist Dr Ste 1
Attn Credentials
Lackland a F B, TX 78236-9908
Mailing address
18614 Eagle FRD
San Antonio, TX 78258-4447
Phone (210) 455-2449
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070-011827 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184835050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18614 EAGLE FRD",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782584447",
"telephone_number": "210-455-2449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 BERGQUIST DR STE 1",
"address_2": "ATTN CREDENTIALS",
"city": "LACKLAND A F B",
"state": "TX",
"postal_code": "782369908",
"telephone_number": "210-292-6225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VITA",
"first_name": "MICHELE",
"middle_name": "TERESE",
"credential": "DPT, OCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lackland a F B, 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.