Mi Physical Medicine

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

5101013386 Issued in MI

Legal business name

MI PHYSICAL MEDICINE

Practice address

3865 W Front St
Suite 5
Traverse City, MI 49684-8101

Phone

(231) 943-1454

NPI assigned

Dec 31, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Christina A Richardson, DONPI 1851499065

Title

Owner

Phone

(231) 943-1454

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christina A Richardson, DO

  • Physical Medicine & Rehabilitation Physician
  • Traverse City, MI
  • NPI 1851499065
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424995200000",
    "number": "1194113993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3865 W FRONT ST",
            "address_2": "SUITE 5",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848101",
            "telephone_number": "231-943-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3865 W FRONT ST",
            "address_2": "SUITE 5",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496848101",
            "telephone_number": "231-943-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MI PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-31",
        "last_updated": "2015-02-27",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-943-1454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5101013386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constance F Metcalf, RD
• Tina Maria Metropoulos, D.O.
• Jaime D. Meyer, PAC
• Paula Susan Meyer, FNP-C
• Erin Dickson Meyers, LLMSW
• Michael C Hutchison PLLC
• Michael J Vanwagner DO PC
• David P Michelin, MD
• Molly Nicole Michelli
• Michigan Medical Supply Inc

• Physical Medicine & Rehabilitation Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; 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.