Individual provider Active NPI

Marta Stern, P.T., D.P.T

  • Mechanotherapist
  • Hudsonville, MI
National Provider Identifier
1205238540
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
5501016893 Issued in MI
Practice address
3152A Port Sheldon Rd.
Hudsonville, MI 49426
Phone
(616) 662-0990
NPI assigned
Sep 18, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X 5501016893 MI Primary

Addresses

Primary practice location

3152A Port Sheldon Rd.
Hudsonville, MI 49426

Mailing address

6876 Northway Dr NE
Rockford, MI 49341-7563

Other identifiers 1

IdentifierTypeStateIssuer
1902977788MedicaidMI

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
5501016893MIMDMechanotherapist

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1205238540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6876 NORTHWAY DR NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493417563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3152A PORT SHELDON RD.",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "49426",
            "telephone_number": "616-662-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "MARTA",
        "credential": "P.T., D.P.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "",
            "desc": "Mechanotherapist",
            "state": "MI",
            "license": "5501016893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902977788",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudsonville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.